New consensus on managing AMI patients during COVID-19 released

Reviewed by Emily Henderson, B.Sc.Apr 21 2020

The Society for Cardiovascular Angiography and Interventions (SCAI), along with the American College of Cardiology (ACC) and American College of Emergency Physicians (ACEP) have released a consensus statement that provides recommendations for a systematic approach for the care of patients with an acute myocardial infarction (AMI) during the coronavirus disease-2019 (COVID-19) pandemic. The document is jointly published in Catheterization and Cardiovascular Interventions, the official journal of SCAI, and the Journal of the American College of Cardiology.

According to recent studies, cardiovascular disease patients who develop COVID-19 have a higher risk of mortality. However, many patients in need of care for the management of various heart diseases may not be infected with this coronavirus. The document identifies several challenges in providing recommendations for AMI care during the COVID-19 epidemic: cardiovascular manifestations in the COVID-19 patient are complex and variable, the prevalence of COVID-19 in U.S. populations remains unknown, and personal protection equipment (PPE) is not uniformly available.

During the COVID-19 pandemic we wanted to ensure that patients continue to benefit from the tremendous advances made in the care of patients with cardiovascular disease over the past three decades. Primary percutaneous coronary intervention (PCI) is the standard of care for STEMI patients, and in this document, we outline an approach to providing that therapy at PCI-capable hospitals while also ensuring health care worker safety with appropriate PPE."

Ehtisham Mahmud, MD, FSCAI, SCAI president and lead author of the writing group

The writing group recommends informing the public that exposure to the virus can be minimized, that that patients continue to call the Emergency Medical System when presenting with acute ischemic heart disease symptoms, with the intention of primary PCI when indicated. Fibrinolysis at referral hospitals (non-PCI capable) is appropriate with a plan of care for rescue or pharmacoinvasive PCI. The document also provides strategies for maximizing the safety of medical personnel with appropriate use of personal protection equipment and masking patients.