case_images: PMC553970_01
case_images: Lead II monitor strip recorded shortly after admission (A) and at the chest pain onset (B).
case_images: 1471-2261-5-6-1.jpg
case_images: PMC553970_01_1471-2261-5-6-1.jpg
case_images: F1
case_images: The patient was then connected to a cardiac monitor, which showed sinus tachycardia (approximately 140 bpm) without ST-segment and T wave abnormalities (Fig. 1A). Almost simultaneously with the administration of the second dose of epinephrine, ST-segment elevation appeared on the monitor (Fig. 1B) and the patient complained of substernal chest pain.
case_images: ECG recorded during chest pain.
case_images: 1471-2261-5-6-2.jpg
case_images: PMC553970_01_1471-2261-5-6-2.jpg
case_images: F2
case_images: A 12-lead electrocardiogram (ECG) showed ST segment elevation in leads II, III, aVF, and V3 to V6 (Fig. 2).
case_images: ECG recorded on hospital day 4th.
case_images: 1471-2261-5-6-3.jpg
case_images: PMC553970_01_1471-2261-5-6-3.jpg
case_images: F3
case_images: An ECG performed before discharge showed complete loss of potentials in leads III and aVF and partial loss of potentials with a small q wave in lead II (Fig. 3).
case_images: Left coronary angiogram.
case_images: 1471-2261-5-6-4.jpg
case_images: PMC553970_01_1471-2261-5-6-4.jpg
case_images: F4
case_images: Left (Fig. 4) and right (Fig. 5) coronary angiography showed no evidence of obstructive coronary artery disease; left ventriculography was normal as well.