case_images: PMC11329600_01
case_images: The patient's electrocardiogram from an external hospital shows ST-segment elevation in the inferior wall, anterior lateral wall, and posterior wall leads.
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case_images: The electrocardiogram (ECG) conducted at the external facility displayed ST-segment elevation in the inferior, anterolateral, and posterior leads (refer to Figure 1), prompting the initiation of dual antiplatelet therapy (aspirin + ticagrelor).
case_images: The pre-PCI electrocardiogram of the patient shows ST-segment elevation in the inferior wall, anterior lateral wall, and posterior wall leads, with no significant change compared to the electrocardiogram from the external hospital.
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case_images: Subsequent ECG indicated persistent ST-segment elevation in the inferior, anterolateral, and posterior leads (see Figure 2).
case_images: Dynamic follow-up of biomarkers.
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case_images: T (50 ng/l) and myoglobin (89 ng/L). The dynamic follow-up of biomarkers after hospitalization is depicted in Figure 3.
case_images: Coronary angiography shows non-obstructive coronary arteries.
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case_images: Emergency coronary angiography, as shown in Figure 4, displayed normal findings.
case_images: Cardiac PET-CT suggests: diffuse elevated myocardial metabolism in the interventricular septum, lateral wall, and inferior wall-apical myocardium; patchy mild metabolism in the right ventricular epicardial region; increased metabolism in the proximal segment of the right coronary artery; mild increase in metabolism in the distal segment of the left circumflex artery, suggestive of myocardial inflammatory changes.
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case_images: Further imaging studies, including PET-CT and myocardial perfusion scintigraphy, were carried out to investigate the etiology of recurrent coronary vasospasm, revealing increased myocardial metabolism in the left ventricular septum, lateral wall, and inferoapical region indicative of ischemia (Figures 5 and 6).
case_images: Myocardial nuclear imaging reveals perfusion-metabolism mismatch in the apical and middle-inferior walls of the heart.
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case_images: Further imaging studies, including PET-CT and myocardial perfusion scintigraphy, were carried out to investigate the etiology of recurrent coronary vasospasm, revealing increased myocardial metabolism in the left ventricular septum, lateral wall, and inferoapical region indicative of ischemia (Figures 5 and 6).