case_images: PMC3923566_01
case_images: Echocardiogram obtained at the time of admission.
case_images: 1752-1947-8-18-1.jpg
case_images: PMC3923566_01_1752-1947-8-18-1.jpg
case_images: F1
case_images: The echocardiogram, which was performed when the patient was pain-free, revealed normal ventricular volume, no segmentary wall hypokinesia with a left ventricular ejection fraction of 72%, normal diastolic heart function, normal valve flow and absence of pericardial effusion (Figure 1).
case_images: Electrocardiogram taken during the anginal episode in the coronary intensive care unit. Sinus bradycardia (50 beats per minute (bpm)) with diffuse ST-segment elevation (arrows) in the anterior leads (V3 to V6) and inferolateral leads (I, II, III, augmented vector left and augmented vector foot) and peaked T-waves (dots) at the same leads are suggestive of transmural ischemia.
case_images: 1752-1947-8-18-2.jpg
case_images: PMC3923566_01_1752-1947-8-18-2.jpg
case_images: F2
case_images: A new ECG was taken immediately and revealed sinus bradycardia (50bpm) with diffuse ST-segment elevation in the anterior leads (V3 to V6) and inferolateral leads (I, II, III, augmented vector left (aVL) and augmented vector foot (aVF)) and peaked T-waves at the same leads (Figure 2), suggestive of transmural ischemia.
case_images: Electrocardiogram taken 20 minutes after the patient's pain resolved. Arrows show progressive recovery of ventricular repolarization abnormalities.
case_images: 1752-1947-8-18-3.jpg
case_images: PMC3923566_01_1752-1947-8-18-3.jpg
case_images: F3
case_images: The ECG that was taken 40 minutes afterward showed progressive recovery of ventricular repolarization abnormalities (Figure 3).
case_images: Coronary angiography images showing normal epicardial coronary artery tree and normal left ventricular function.
case_images: 1752-1947-8-18-4.jpg
case_images: PMC3923566_01_1752-1947-8-18-4.jpg
case_images: F4
case_images: CTnI, remained within the normal range. Coronary and ventricular angiography performed 48 hours later revealed a normal epicardial coronary artery tree and normal left ventricular function (Figure 4).