case_images: PMC11748142_01
case_images: Complete heart block on presentation. Electrocardiogram demonstrating atrioventricular dissociation, junctional beats, and premature ventricular contractions are present.
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case_images: The initial electrocardiogram (ECG) showed complete heart block (Figure 1), and transcutaneous pacing was initiated prior to transfer to the cardiac catheterization lab.
case_images: Coronary angiography. Left panel showing the right coronary artery in the left anterior oblique view. Right panel showing the left anterior descending and left circumflex arteries from the right anterior oblique view. There is no significant stenosis visualized.
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case_images: Coronary angiography demonstrated a minor spasm in the left anterior descending artery in the setting of multiple pressors but no significant coronary artery disease (Figure 2).
case_images: Cardiac magnetic resonance imaging T1 mapping. T1-weighted short-axis view demonstrating globally elevated T1 signal intensity, suggestive of non-ischaemic myocardial injury (diffuse fibrosis/infiltration).
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case_images: On Day 11, cardiac magnetic resonance (CMR) imaging demonstrated globally elevated T1 signal intensity and increased extracellular volume in the LV, suggestive of non-ischaemic myocardial injury (Figure 3).
case_images: Cardiac magnetic resonance imaging T2 mapping. T2-weighted short-axis view demonstrating elevated T2 signal intensity in the basal inferolateral region, indicative of oedema.
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case_images: T2 signal intensity, indicative of myocardial oedema (Figure 4).