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Streptokinase in a COVID-19-positive patient with STEMI in a PPCI centre: a local experience
  1. Nasir Rahman,
  2. Ihsan Ullah and
  3. Ghufran Adnan
  1. Department of Medicine, Section of Cardiology, Aga Khan University Hospital, Karachi, Pakistan
  1. Correspondence to Dr Nasir Rahman; nasir.rahman{at}


Primary percutaneous coronary intervention is the recommended modality of treatment for acute ST-elevation myocardial infarction (STEMI). However, different countries now have different consensus about treatment of patients with STEMI during the COVID-19 pandemic. In this report, we describe a case of SARS-CoV-2-positive patient admitted with pneumonia. During hospital stay in COVID-19 designated special care, the patient developed inferoposterior wall myocardial infarction (MI) without haemodynamic instability and was treated successfully with thrombolytics (streptokinase) without any severe complications. To decrease the risk of in-hospital exposure to COVID-19 infection among the staff, in circumstances where there is no negative-pressure catheterisation laboratory and there is shortage in medical staff, thrombolytics can be used as a modality of treatment in low-risk, haemodynamically stable MI during this pandemic, as recommended by different cardiac societies. However, this needs further studies in order to reach local and international consensus.

  • cardiovascular medicine
  • ischaemic heart disease

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  • Contributors IU wrote the manuscript. GA helped in writing the manuscript. NR supervised and made final changes to the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.