case_images: PMC8545905_01
case_images: Electrocardiogram and Chest X-ray. (A) ECG showed sinus rhythm, 60 bpm, normal axis, fragmented QRS in the inferior leads (III, aVF) and flat T waves in III, aVF and V6. When compared to previous ECGs, no new abnormalities were observed. (B) Chest X-ray with a single lead ICD, normal heart size and no signs of pulmonary congestion.
case_images: fcvm-08-759119-g0001.jpg
case_images: PMC8545905_01_fcvm-08-759119-g0001.jpg
case_images: F1
case_images: T waves in the inferior leads; no new abnormalities were identified when compared to previous ECG. There were no signs of heart failure in the chest X-ray (Figure 1).
case_images: Echocardiography. Parasternal long axis view showed mild left ventricular enlargement, both left ventricular end-diastolic (A) and end-systolic (B) diameters. Right ventricle, ascending aorta and left atrium were of normal size. Interventricular septum and posterior left ventricular wall had normal thickness. No pericardial effusion was observed.
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case_images: PMC8545905_01_fcvm-08-759119-g0002.jpg
case_images: F2
case_images: The echocardiographic assessment showed mild left ventricular enlargement (Figure 2) with moderate left ventricular systolic dysfunction (Supplementary Videos 1,2).
case_images: Dynamic of high sensitivity cardiac troponin I levels. Hs-cTnI levels peaked at admission. Three days later, with ongoing recurrent episodes of chest pain, a further increase in hs-cTnI value was observed. After starting aspirin and colchicine, chest pain resolved and hs-cTnI levels progressively decreased. At discharge, hs-cTnI value was almost normal (normal range 0-58.05 ng/l).
case_images: fcvm-08-759119-g0003.jpg
case_images: PMC8545905_01_fcvm-08-759119-g0003.jpg
case_images: F3
case_images: After the fifth day of stay, symptoms progressively ameliorated and, 5 days later, the patient was discharged with mild muscle weakness and almost normal hs-cTnI levels (Figure 3).