case_images: PMC10749520_01
case_images: Patient's initial 12-lead EKG: Normal sinus rhythm with sinus arrhythmia, rightward axis, QR and RSR' patterns in V1 and V2 suggest but do not meet criteria for right ventricular conduction delay given a normal QRS duration (96 ms). There is also borderline J point elevation (0.5 mm) in lateral leads.. Abbreviation: EKG, electrocardiogram.
case_images: 10.1177_23247096231217969-fig1.jpg
case_images: PMC10749520_01_10.1177_23247096231217969-fig1.jpg
case_images: fig1-23247096231217969
case_images: Electrocardiogram showed borderline J point elevations in lateral leads (Figure 1).
case_images: Coronary angiogram (I-II) showing spontaneous coronary artery dissection (SCAD) involving the left anterior descending artery (LAD) depicted as the long and smooth narrowing of the LAD segment between a and b:type 2 SCAD. The left ventriculography (III-IV) shows the heart during diastole (III) and at systole (IV) with apical akinesis and basal hyperkinesis depicting the classic apical ballooning/mid-ventricular ballooning of stress cardiomyopathy.
case_images: 10.1177_23247096231217969-fig2.jpg
case_images: PMC10749520_01_10.1177_23247096231217969-fig2.jpg
case_images: fig2-23247096231217969
case_images: The patient underwent emergent coronary angiography which revealed SCAD of the LAD (Figure 2).
case_images: Computed tomographic angiogram (CTA) of the neck (A) showing bilateral focal area of mild stenosis and dilation involving distal cervical internal carotid artery (gray arrows).
case_images: 10.1177_23247096231217969-fig3.jpg
case_images: PMC10749520_01_10.1177_23247096231217969-fig3.jpg
case_images: fig3-23247096231217969
case_images: The CTA neck showed a bilateral focal area of mild stenosis and dilation involving the distal cervical internal carotid artery (ICA) (Figure 3).