case_images: PMC10510344_01
case_images: ECG in outpatient office (a) and on hospital admission (b).. Temporal sequence of obtained electrocardiograms, showing a transient left bundle branch block and T-wave inversions in leads V1-V4 that corresponded with the patient's chest pain on initial presentation.
case_images: 10.1177_17539447231196758-fig1.jpg
case_images: PMC10510344_01_10.1177_17539447231196758-fig1.jpg
case_images: fig1-17539447231196758
case_images: Electrocardiogram (ECG) performed in the primary care office demonstrated normal conduction with a heart rate of 76 beats/min, but new T-wave inversions in V1-V4 (Figure 1(a)) and a high-sensitivity troponin-I (hsTnI) value of 6 ng/L (normal < 6 ng/L). ECG in the emergency department showed normal sinus rhythm with a heart of 80 beats/min with a left bundle branch block (LBBB) characterized by a QRS complex duration of 146 ms [Figure 1(b)] and a repeat hsTnI of 7 ng/L.
case_images: Coronary computed tomography angiography obtained during hospital admission.. Imaging significant for a total Agatston CAC score of 1262, distributed across the left main (200), left anterior descending (166), left circumflex (553), and right coronary arteries (342). Stenosis severity across the left main, left anterior descending, left circumflex, and right coronary arteries were between 25% and 49%.
case_images: 10.1177_17539447231196758-fig2.jpg
case_images: PMC10510344_01_10.1177_17539447231196758-fig2.jpg
case_images: fig2-17539447231196758
case_images: The total Agatston CAC score was 1262, distributed as LM 200, LAD 166, LCx 553, and RCA 342 (Figure 2).
case_images: ECG on hospital discharge.. Resolution of the LBBB and precordial T-wave inversions.. LBBB, left bundle branch block.
case_images: 10.1177_17539447231196758-fig3.jpg
case_images: PMC10510344_01_10.1177_17539447231196758-fig3.jpg
case_images: fig3-17539447231196758
case_images: ECG on discharge showed resolution of the LBBB and precordial T-wave inversions with a heart rate of 73 beats/min (Figure 3).