case_images: PMC6803752_01
case_images: EKG on presentation showing sinus rhythm with prolonged PR interval.
case_images: CRIC2019-2576373.001.jpg
case_images: PMC6803752_01_CRIC2019-2576373.001.jpg
case_images: fig1
case_images: Initial EKG showed no acute changes but prolonged PR interval of 324 milliseconds (Figure 1).
case_images: Coronary angiogram showing LAD caudal view.
case_images: CRIC2019-2576373.002.jpg
case_images: PMC6803752_01_CRIC2019-2576373.002.jpg
case_images: fig2
case_images: Coronary angiogram demonstrated a nonobstructive coronary artery disease (Figures 2 and 3) with a ventriculogram showing apical ballooning and ejection fraction of 40% suggestive of takotsubo cardiomyopathy (Figures 4 and 5).
case_images: Coronary angiogram showing a view of the right coronary artery.
case_images: CRIC2019-2576373.003.jpg
case_images: PMC6803752_01_CRIC2019-2576373.003.jpg
case_images: fig3
case_images: Coronary angiogram demonstrated a nonobstructive coronary artery disease (Figures 2 and 3) with a ventriculogram showing apical ballooning and ejection fraction of 40% suggestive of takotsubo cardiomyopathy (Figures 4 and 5).
case_images: Left ventriculogram in systole.
case_images: CRIC2019-2576373.004.jpg
case_images: PMC6803752_01_CRIC2019-2576373.004.jpg
case_images: fig4
case_images: Coronary angiogram demonstrated a nonobstructive coronary artery disease (Figures 2 and 3) with a ventriculogram showing apical ballooning and ejection fraction of 40% suggestive of takotsubo cardiomyopathy (Figures 4 and 5).
case_images: Left ventriculogram in diastole.
case_images: CRIC2019-2576373.005.jpg
case_images: PMC6803752_01_CRIC2019-2576373.005.jpg
case_images: fig5
case_images: Coronary angiogram demonstrated a nonobstructive coronary artery disease (Figures 2 and 3) with a ventriculogram showing apical ballooning and ejection fraction of 40% suggestive of takotsubo cardiomyopathy (Figures 4 and 5).
case_images: Apical 4 chamber ECHO view (a) on presentation suggestive of takotsubo cardiomyopathy followed by repeat apical 4 chamber view (b) two months later showing recovery of previously noted wall motion abnormalities.
case_images: CRIC2019-2576373.006.jpg
case_images: PMC6803752_01_CRIC2019-2576373.006.jpg
case_images: fig6
case_images: The patient was admitted to the CCU, and a transthoracic echo was done and consistent with the findings of coronary catheterization: it showed an ejection fraction of 45% with hyperdynamic inferobasal and anterior basal walls with apical ballooning indicative of takotsubo cardiomyopathy (Figure 6). A repeat echocardiogram was done outpatient, two months after hospitalization, and showed improvement: she had an ejection fraction of 55-60% with resolution of the apical ballooning and hyperdynamic wall motion changes, which were initially noted during hospitalization (Figure 6).
case_images: EKG showing Mobitz type 1 AV block.
case_images: CRIC2019-2576373.007.jpg
case_images: PMC6803752_01_CRIC2019-2576373.007.jpg
case_images: fig7
case_images: Her hospitalization was complicated by Mobitz 1 AV block (Figure 7), wide complex escape rhythms, and subsequent complete heart block (Figure 8).
case_images: EKG showing third degree complete AV block.
case_images: CRIC2019-2576373.008.jpg
case_images: PMC6803752_01_CRIC2019-2576373.008.jpg
case_images: fig8
case_images: Her hospitalization was complicated by Mobitz 1 AV block (Figure 7), wide complex escape rhythms, and subsequent complete heart block (Figure 8).