Introduction: Management of a patient with acute myocardial infarction (AMI) is complex and requires a good cooperation between physicians and nurses/technicians. At the time of the SARS-CoV-2 pandemic the care of such patients is even more complex. (1) The virus posed new challenges in the treatment and care of patients with AMI. Some people may feel the symptoms of heart disease but because of the risk of a pandemic they will not go to general practitioner or to the emergency department. Despite that, one should always keep in mind that early treatment saves lives. The aim of this paper was to show how at the time of the SARS-CoV-2 pandemic there is a complex care and treatment of patients with AMI, and how nursing interventions were carried out in such situations.
Case report: 63-year-old patient was admitted to the Department of Intensive Cardiac Care with an AMI. Chest pain witch spreads to the left arm all the way to the elbow, that occurred after walking on a straight line of 100 metres was the reason that this patient came to the Emergency Department. The patient also states that he has a positive epidemiological history for COVID-19 infection. During the treatment in the Emergency Department, an electrocardiogram was performed, which showed myocardial infarction with ST-segment elevation. Along with the ECG, the patient’s blood was drawn, and a nasal swab for the SARS-CoV-2 virus was routinely taken. After the arrival of cardioselective enzymes the patient was prepared for urgent coronary angiography. At the Catheterization Lab coronary angiography and percutaneous coronary intervention was performed. Right coronary artery was occluded. After predilatation two drug eluting stents (Ultimaster 3.5/28 mm and Angiolite 4.0/16 mm) were placed in the right coronary artery. In the final coronary angiogram, there were no residual stenoses with TIMI III flow.
The nurses and technicians were adequately prepared according to the instructions of the Croatian Institute of Public Health since the patient had a positive epidemiological history. After the coronary angiography patient was transferred to the Department of Intensive Care where all epidemiological measures were taken by the staff. After initial acute treatment the test for SARS-CoV-2 arrived positive. The patient was transported to University Hospital Dubrava which was a respiratory intensive care center.