# Severe Coronary Vasospasms in Asymptomatic COVID-19

## TL;DR

A patient with asymptomatic COVID-19 developed a heart attack due to severe coronary vasospasm, showing that the virus can cause serious cardiovascular issues even without symptoms.

## Contribution

This case report highlights the novel finding of STEMI caused by coronary vasospasm in an asymptomatic COVID-19 patient.

## Key findings

- An asymptomatic COVID-19 patient developed STEMI due to coronary vasospasm.
- Angiography confirmed significant vasospasm that improved with nitroglycerin.
- The case suggests that SARS-CoV-2 may cause cardiovascular complications through vasospastic mechanisms.

## Abstract

Since the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019, we have witnessed its multi-organ system involvement, not limiting itself to the lungs. We present a case of a patient with asymptomatic coronavirus disease 2019 (COVID-19) infection who developed ST-elevation myocardial infarction (STEMI) due to coronary artery vasospasm. The patient exhibited symptoms of acute coronary syndrome, elevated troponins, and electrocardiographic changes consistent with STEMI. He was found to have significant coronary vasospasm on angiography that responded well to nitroglycerin. This case highlights the potential cardiovascular complications of COVID-19 infection, even when asymptomatic, and the importance of considering vasospasm as a possible mechanism in patients presenting with acute coronary syndrome. We also elaborate on some potential pathophysiological mechanisms in which COVID-19 may lead to coronary vasospasm.