case_images: PMC11144857_01
case_images: The first ECG on arrival and before CABG, which illustrates normal sinus rhythm with low voltage QRS and prolonged qTcB (505 ms), in addition to findings compatible with inferolateral STEMI.
case_images: fcvm-11-1331873-g001.jpg
case_images: PMC11144857_01_fcvm-11-1331873-g001.jpg
case_images: F1
case_images: He was diagnosed with an inferolateral ST-elevation MI, accompanied by a prolonged QTc interval on the first electrocardiogram (ECG) (Figure 1) and transferred to the catheterization laboratory for emergency coronary angiography, which revealed significant stenosis in the terminal end of the left main artery, in addition to advanced three-vessel disease. The post-CABG ECG of the patient (in ICU) illustrated normal sinus rhythm with low voltage QRS, and bigeminal ventricular extrasystole (PVCs) with short coupling interval (R on T wave; Supplementary Figure S1).
case_images: The tracing shows bigeminal PVBs with short coupling intervals (R on T), which degenerated into torsade de pointes.
case_images: fcvm-11-1331873-g002.jpg
case_images: PMC11144857_01_fcvm-11-1331873-g002.jpg
case_images: F2
case_images: On the same day (2 days after the surgery), he developed recurrent episodes of TdP (Figure 2), one of them degenerated into VF, causing cardiovascular collapse.
case_images: (A) Post-contrast axial CT scan image during pulmonary arterial phase, which shows high soft tissue density lesion in the anterior mediastinum with hounsfiled unit (HU) consistent with clotted blood (HU = 81). Also note the presence of mild left-sided bloody pleural effusion (HU = 45), associated with the underlying collapse of the posterior basal segment of the left lower lobe and a lesser degree of segmental atelectasis of the posterior basal segment of the right lower lobe, all secondary to recent CABG operation. (B) MPR images show narrowing of RVOT secondary to external pressure effect by retrosternal hematoma (arrows).
case_images: fcvm-11-1331873-g003.jpg
case_images: PMC11144857_01_fcvm-11-1331873-g003.jpg
case_images: F3
case_images: Post-contrast scan illustrated a high soft tissue density lesion in the anterior mediastinum with Hounsfiled unit (HU) consistent with clotted blood (Figure 3).