case_images: PMC3385192_01
case_images: Chest skiagram showing pulmonary edema
case_images: HV-13-16-g001.jpg
case_images: PMC3385192_01_HV-13-16-g001.jpg
case_images: F1
case_images: Chest skiagram revealed pulmonary edema [Figure 1].
case_images: (a) Electrocardiogram showing sinus tachycardia with secondary "ST-T" changes. (b) ECG on the next day showing normal sinus rhythm with "T"-wave inversions in leads I, aVL, V1 and V2, and ST segment elevation with concavity upward in leads II, III, aVF and V5, and V6
case_images: HV-13-16-g002.jpg
case_images: PMC3385192_01_HV-13-16-g002.jpg
case_images: F2
case_images: Electrocardiogram [Figure 2a] showed sinus tachycardia with secondary "ST-T" changes. ECG on the next day [Figure 2b] revealed normal sinus rhythm with "T"-wave inversions in leads I, aVL, V1 and V2, and ST segment elevation with concavity upward in leads II, III, aVF and V5, and V6. Echocardiogram demonstrated hypokinesia of interventricular septum and inferior posterior wall with moderate mitral and tricuspid regurgitation and left ventricular ejection fraction (LVEF) 28% [Figure 3a and b].
case_images: (a) Echocardiogram (apical four-chamber view) demonstrating hypokinesia of interventricular septum, (b) Echocardiogram (parasternal long axis view M mode) demonstrating hypokinesia of interventricular septum and inferior posterior wall with LVEF 28%
case_images: HV-13-16-g003.jpg
case_images: PMC3385192_01_HV-13-16-g003.jpg
case_images: F3
case_images: ECG on the next day [Figure 2b] revealed normal sinus rhythm with "T"-wave inversions in leads I, aVL, V1 and V2, and ST segment elevation with concavity upward in leads II, III, aVF and V5, and V6. Echocardiogram demonstrated hypokinesia of interventricular septum and inferior posterior wall with moderate mitral and tricuspid regurgitation and left ventricular ejection fraction (LVEF) 28% [Figure 3a and b].
case_images: Left coronary angiogram showing normal left anterior descending and left circumflex arteries
case_images: HV-13-16-g004.jpg
case_images: PMC3385192_01_HV-13-16-g004.jpg
case_images: F4
case_images: Finally, coronary angiogram was performed which revealed normal coronary vessels [Figures 4 and 5] with positive ergonovine and acetylcholine challenge test for coronary artery vasospasm.
case_images: Right coronary angiogram showing normal right coronary artery
case_images: HV-13-16-g005.jpg
case_images: PMC3385192_01_HV-13-16-g005.jpg
case_images: F5
case_images: Finally, coronary angiogram was performed which revealed normal coronary vessels [Figures 4 and 5] with positive ergonovine and acetylcholine challenge test for coronary artery vasospasm.