case_images: PMC10999312_01
case_images: (A) Initial coronary angiography showing a non-significant lesion in the first diagonal artery (black arrow). (B) Initialcoronary angiography with dominant right coronary artery without lesions. (C) Second coronary angiography showing severe 70% stenosis of the proximal circumflex artery (white arrow) and severe lesions at the origin (white arrowhead) and proximal third (black arrowhead) of the obtuse marginal branch. D) Second coronary angiography showing severe 80% stenosis in the distal third of the right coronary artery (black arrowhead).
case_images: apcyccv-5-40-gf1.jpg
case_images: PMC10999312_01_apcyccv-5-40-gf1.jpg
case_images: f1
case_images: Coronary angiography showed a non-significant lesion in the first diagonal artery (Figure 1A and 1B); echocardiography revealed no abnormalities in myocardial contractility and an ejection fraction of 60%. An electrocardiogram showed evidence of repolarization disorder in the lateral wall, and further evaluation with high-sensitivity troponin and repeat coronary angiography revealed significant multivessel coronary artery disease (Figure 1C and 1D), with indication for revascularization.
case_images: Contrast-enhanced chest tomography. Honeycombing involving apices and bases, predominantly in the subpleural and basal regions.
case_images: apcyccv-5-40-gf2.jpg
case_images: PMC10999312_01_apcyccv-5-40-gf2.jpg
case_images: f2
case_images: Given the findings of pulmonary auscultation and respiratory symptoms, a chest X-ray was performed (Figure 2), which revealed findings consistent with interstitial pneumonia.