case_images: PMC5661151_01
case_images: A. Coronary angiography before PCI. B. ECG after PCI. C. Control angiography. Significant stenosis is seen in the circumflex artery (A) and there is no contrast dye leakage in the control angiography (C) in the right caudal position. There is ST segment elevation in D1 and aVL deviations, suggesting a new-onset acute coronary syndrome.
case_images: cvja-28-e10-g001.jpg
case_images: PMC5661151_01_cvja-28-e10-g001.jpg
case_images: F1
case_images: CABG carried out in 2011. Coronary angiography revealed severe stenosis (99%) in the middle part of the circumflex artery (Cx) (Fig. 1A). An ECG showed ST elevations in D1 and aVL deviations (Fig. 1B). We saw no thrombus in the stent but noticed deterioration of blood flow in the intermediate artery (Fig. 1C).
case_images: A. Transthoracic echocardiography. B, C. Axial and sagittal computed tomography sections of the heart. Intra-myocardial haematoma is seen in both echocardiography and computed tomography (asterisk). LV, left ventricle; LA, left atrium.
case_images: cvja-28-e10-g002.jpg
case_images: PMC5661151_01_cvja-28-e10-g002.jpg
case_images: F2
case_images: Two-dimensional echocardiography revealed a large 5.1 x 1.4-cm echolucent area without fluid in the pericardium (Fig. 2A). On day three of the follow up, cardiac computed tomography revealed thickening of the lateral wall of the myocardium, a radiolucent centre without contrast dye, and bilateral pleural effusions with no pericardial effusion (Fig. 2B, C).