case_images: PMC11799367_01
case_images: 12-lead ECG of the patient showing T wave changes, as indicated by the red arrows.. ECG: Electrocardiogram.
case_images: cureus-0017-00000077041-i01.jpg
case_images: PMC11799367_01_cureus-0017-00000077041-i01.jpg
case_images: FIG1
case_images: T wave inversion in I and aVL leads along with v4-v6 leads, as shown in Figure 1. This, along with raised cardiac biomarkers (ckmb-49, hscTnI-68), was suggestive of ischemic etiology, and hence a diagnosis of NSTEMI with hypertensive crisis was made.
case_images: Coronary angiogram: A) depicting normal RCA (black arrow); B) depicting normal LMCA (black arrow) and normal LAD (white arrow).. RCA: Right Coronary Artery; LMCA: Left Main Coronary Artery; LAD: Left Anterior Descending Artery.
case_images: cureus-0017-00000077041-i02.jpg
case_images: PMC11799367_01_cureus-0017-00000077041-i02.jpg
case_images: FIG2
case_images: Coronary angiography was performed, suggestive of normal epicardial coronaries, as shown in Figure 2.
case_images: Image depicting abdominal striae (red arrows), which are a typical feature of Cushing's syndrome.
case_images: cureus-0017-00000077041-i03.jpg
case_images: PMC11799367_01_cureus-0017-00000077041-i03.jpg
case_images: FIG3
case_images: An Endocrinology consultation was taken in view of cushingoid-like features as shown in Figures 3-4, and a diagnosis of exogenous Cushing's (steroid-induced suppressed cortisol) was made due to long-term use of steroids, and he was advised a low dose dexamethasone suppression test to rule out Cushing's syndrome.
case_images: Cushingoid features: A) Moon face (red arrow); B) Skin fragility (red arrow); C) Slender fingers (red arrow).
case_images: cureus-0017-00000077041-i04.jpg
case_images: PMC11799367_01_cureus-0017-00000077041-i04.jpg
case_images: FIG4
case_images: An Endocrinology consultation was taken in view of cushingoid-like features as shown in Figures 3-4, and a diagnosis of exogenous Cushing's (steroid-induced suppressed cortisol) was made due to long-term use of steroids, and he was advised a low dose dexamethasone suppression test to rule out Cushing's syndrome.
case_images: Summary of the timeline of events leading to MINOCA.. ENL: Erythema nodosum leprosum; NYHA: New York Heart Association; CKMB: Creatine kinase myoglobin binding; hs-cTnI: High sensitivity cardiac troponin I; NSTEMI: Non-ST segment elevation myocardial infarction; MINOCA: Myocardial infarction with non-obstructive coronary arteries.
case_images: cureus-0017-00000077041-i05.jpg
case_images: PMC11799367_01_cureus-0017-00000077041-i05.jpg
case_images: FIG5