case_images: PMC9242792_01
case_images: Electrocardiogram at presentation.
case_images: CRIC2022-5413237.001.jpg
case_images: PMC9242792_01_CRIC2022-5413237.001.jpg
case_images: fig1
case_images: Initial troponin was normal 0.002 ng/mL (<0.045), and electrocardiogram revealed sinus tachycardia and ventricular rate of 121 with no repolarization abnormalities (Figure 1).
case_images: Electrocardiogram on admission day 3.
case_images: CRIC2022-5413237.002.jpg
case_images: PMC9242792_01_CRIC2022-5413237.002.jpg
case_images: fig2
case_images: However, on admission day three, he developed new onset atrial fibrillation with rapid ventricular response, chest pain, refractory hypotension, and EKG indicating anterior ST-elevation myocardial infarction (Figure 2).
case_images: (a) Ventriculography of the left ventricle in systole showing basal and midventricular hypokinesis. (b) Ventriculography of the left ventricle in diastole. (c) Coronary angiography showing normal coronaries.
case_images: CRIC2022-5413237.003.jpg
case_images: PMC9242792_01_CRIC2022-5413237.003.jpg
case_images: fig3
case_images: Coronary angiography with ventriculography revealed normal coronaries, basal and midventricular hypokinesis with hyperdynamic left ventricular apex, and ejection fraction of 35%, indicating reverse and midventricular takotsubo cardiomyopathy (Figures 3(a)-3(c)).