case_images: PMC11058217_01
case_images: Chest computed tomography (CT) and electrocardiogram (ECG) on admission. (A) The chest CT scans revealed consolidation and patchy infiltrates within the right lower lobe and the left lower lobe. (B) The ECG showed sinus tachycardia accompanied by ST-T alterations.
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case_images: F1
case_images: The chest computed tomography (CT) scan images on admission indicated consolidation of the right lower lobe and patchy infiltrates at the left lower lobe (Figure 1A), and the ECG showed sinus tachycardia and ST-T changes (Figure 1B). With the initial support, both lung edema and hemodynamic condition showed rapid improvement (Figure 2A, Table 1).
case_images: Chest radiographs and echocardiograms in the intensive care unit (ICU). (A) Chest radiographs on the initial three days of ICU admission. Lung edema exhibited a rapid amelioration. (B) On ICU admission, the apical 4-chamber views of the echocardiography indicated enlarged left atrium and ventricle, along with apical thrombi (indicated by red arrows) in the dilated left ventricle. RV, right ventricle; RA, right atrium; LV, left ventricle; LA, left atrium.
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case_images: F2
case_images: To alleviate cardiac preload and pulmonary edema (Figure 2A), non-invasive ventilation was intermittently employed. The echocardiography conducted in ICU indicated prominently decreased left ventricle contractility with an EF of 26%, enlarged left atrium and ventricle [Left ventricular end-diastolic volume (LVEDV) 223 ml], along with apical thrombi in the dilated left ventricle (Figure 2B). With the initial support, both lung edema and hemodynamic condition showed rapid improvement (Figure 2A, Table 1).
case_images: Brain computed tomography (CT) and magnetic resonance (MR) images. (A) Brain CT on ICU Day 17 revealed an acute infarction of a large area of left middle cerebral artery territory (red arrow). (B) The post-ICU discharge brain MRI showed hyperintense regions (red arrow) in the left frontotemporal and basal ganglia areas. (C) Brain MR angiography revealed diminished perfusion in the intracranial segment of the left cervical internal carotid artery left, along with occlusion of the left middle cerebral artery (red arrow).
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case_images: PMC11058217_01_fcvm-11-1347885-g003.jpg
case_images: F3
case_images: This was likely attributed to the dislodgement of the left ventricular thrombus, a finding subsequently confirmed by magnetic resonance imaging and magnetic resonance angiography after discharged from ICU (Figure 3).