Abstract

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has posed many challenges to emergency physicians with various unexpected clinical presentations. Although the majority of the admissions to the emergency department are related to respiratory symptoms and signs, cardiovascular presentations are not uncommon. We report a 50-year-old male who was brought to the emergency department following successful out of hospital cardiopulmonary resuscitation. The post-cardiac arrest electrocardiogram demonstrated ST segment elevation in the lateral chest leads and a chest radiograph performed in the emergency department showed extensive bilateral consolidation. A subsequent COVID-19 PCR (polymerase chain reaction) test was positive. To our knowledge and as per the literature reviewed, this is an uncommon presentation of COVID-19 with an acute ST-elevation myocardial infarction complicated by out of hospital ventricular fibrillation cardiac arrest. COVID-19 has been associated with various cardiac complications like myocarditis, cardiac failure, STEMI, cardiomyopathy. Presentation of COVID-19 with such cardiac complications carries a guarded prognosis.