case_images: PMC3891079_01
case_images: Electrocardiography showed sinus tachycardia with non-specific ST segment changes.
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case_images: PMC3891079_01_kjim-20-325-g001.jpg
case_images: F1
case_images: (A) Trans-thoracic echocardiography (TTE) showed akinesia in the anterior and, septal wall motion and left ventricular systolic dysfunction (ejection fraction = 38%). (B) The follow-up TTE revealed a remarkably improved anterior and septal wall motion and good left ventricular systolic function with a 62% ejection fraction.
case_images: kjim-20-325-g002.jpg
case_images: PMC3891079_01_kjim-20-325-g002.jpg
case_images: F2
case_images: T: 2.17 ng/mL, cardiac specific troponin I: 9.19 ng/mL, myoglobin: 190.2 ng/mL). Trans-thoracic echocardiography (TTE) showed the dilated left ventricle (LV) with a chamber size of 60 mm for the end-diastolic dimension; akinesia of the anterior and, septal wall motion and LV systolic dysfunction (ejection fraction: 38%) were also observed (Figure 2A). TTE was done on the eighth hospital day, and it revealed normalized LV wall motion (Figure 2B). The blood urea nitrogen (BUN) and creatinine reached their peak levels on the ninth hospital day (blood urea nitrogen: 110.9 mg/dL, creatinine: 8.0 mg/dL) and then they progressively declined.
case_images: (A) Myocardial single photon emission computed tomography (M-SPECT) revealed a large perfusion defect with partial reversibility in the territory of the left anterior descending coronary artery. (B) Follow-up M-SPECT demonstrated an improved perfusion defect in the territory of the left anterior descending coronary artery.
case_images: kjim-20-325-g003.jpg
case_images: PMC3891079_01_kjim-20-325-g003.jpg
case_images: F3
case_images: On the fourth hospital day, myocardial single photon emission computed tomography (M-SPECT) was performed and the M-SPECT revealed a large, partly reversible perfusion defect in the anterior wall on stress, and the resting image suggesting anterior wall myocardial infarction (Figure 3A). Follow-up M-SPECT revealed markedly improved perfusion in the territory of the left anterior descending coronary artery with the remaining perfusion defect (Figure 3B).
case_images: A diagnostic coronary angiogram revealed no significant stenosis in both the coronary arteries.
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case_images: PMC3891079_01_kjim-20-325-g004.jpg
case_images: F4
case_images: The CAG revealed no significant stenosis in both the coronary arteries (Figure 4).