case_images: PMC10862529_01
case_images: PET scan done at the patient presentation (October 2023) showing LAD stent.. LAD: left anterior descending artery.
case_images: cureus-0016-00000052241-i01.jpg
case_images: PMC10862529_01_cureus-0016-00000052241-i01.jpg
case_images: FIG1
case_images: Furthermore, the patient had anterior non-ST segment elevation myocardial infarction (NSTEMI) two weeks prior to this presentation, and percutaneous coronary intervention (PCI) to the left anterior descending artery (LAD) was done (Figure 1).
case_images: T-wave inversion in almost all leads and ST depression in V4, V5, and V6.. This ECG was done at this presentation, and it showed T wave inversion in almost all leads in addition to ST depression in V4, V5, and V6.
case_images: cureus-0016-00000052241-i02.jpg
case_images: PMC10862529_01_cureus-0016-00000052241-i02.jpg
case_images: FIG2
case_images: T-wave inversion in almost all leads and ST depression in V4, V5, and V6; both were old changes (Figure 2).
case_images: PMC10862529_02
case_images: Normal ECG done in 2002.
case_images: cureus-0016-00000052241-i03.jpg
case_images: PMC10862529_02_cureus-0016-00000052241-i03.jpg
case_images: FIG3
case_images: When reviewing the patient's previous ECG, we found that in the 2002 and 2009 ECGs (Figures 3, 4), at that time, the patient was 42 and 49 years old, respectively, and no changes were noted.
case_images: Normal ECG done in 2009.
case_images: cureus-0016-00000052241-i04.jpg
case_images: PMC10862529_02_cureus-0016-00000052241-i04.jpg
case_images: FIG4
case_images: When reviewing the patient's previous ECG, we found that in the 2002 and 2009 ECGs (Figures 3, 4), at that time, the patient was 42 and 49 years old, respectively, and no changes were noted.
case_images: ECG done in 2015: QT segment prolongation and T-wave inversion in V4, V5, and V6.
case_images: cureus-0016-00000052241-i05.jpg
case_images: PMC10862529_02_cureus-0016-00000052241-i05.jpg
case_images: FIG5
case_images: The beginning of the changes was noted in an ECG done in 2015 at the age of 55, which was QT segment prolongation and T-wave inversion in V4, V5, and V6 (Figure 5).
case_images: ECG done in 2020: T-wave inversion became deeper compared to the 2015 ECG.
case_images: cureus-0016-00000052241-i06.jpg
case_images: PMC10862529_02_cureus-0016-00000052241-i06.jpg
case_images: FIG6
case_images: An ECG was obtained at that time, and the T-wave inversion became deeper compared to the 2015 ECG (Figure 6).
case_images: PET scan done at the presentation (in 2023).. Rest PET test showing spade-like cavity.
case_images: cureus-0016-00000052241-i07.jpg
case_images: PMC10862529_02_cureus-0016-00000052241-i07.jpg
case_images: FIG7
case_images: During this presentation, a PET scan was done and showed a clear spade-like cavity (Figure 7).
case_images: PET scan done at the presentation (in 2023).. Stress PET test showing wall defect in the apex of the left ventricle, reflecting LAD ischemia. LAD: left anterior descending artery.
case_images: cureus-0016-00000052241-i08.jpg
case_images: PMC10862529_02_cureus-0016-00000052241-i08.jpg
case_images: FIG8
case_images: Resting PET confirmed the reversibility of LAD ischemia (Figures 8, 9).
case_images: PET scan done at the presentation (in 2023).. Showing perfusion defect, suggestive moderate reversible LAD ischemia. LAD: left anterior descending artery.
case_images: cureus-0016-00000052241-i09.jpg
case_images: PMC10862529_02_cureus-0016-00000052241-i09.jpg
case_images: FIG9
case_images: Resting PET confirmed the reversibility of LAD ischemia (Figures 8, 9).