case_images: PMC10877037_01
case_images: First electrocardiogram outside the hospital. (A) Fist electrocardiogram showed sinus rhythm and ST segment elevation in lead V1-V3. (B) An hour later, a repeat electrocardiogram showed sinus rhythm with ST-segment elevation in leads V1-V4. (C) Electrocardiogram of the patient after antiallergic treatment.
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case_images: F1
case_images: Auxiliary examination: ECG showed sinus rhythm and ST segment elevation in lead V1-V3 (Figure 1A). An hour later, a repeat ECG showed sinus rhythm with ST-segment elevation in leads V1-V4 (Figure 1B). We considered that coronary spasm was caused by allergic reaction induced by the secretion of Cryptopteran.After intravenous drip of calcium gluconate injection, topical halometasone ointment, and oral loratadine treatment, the patient's symptoms improved, and the reexamination of electrocardiogram and troponin were normal (Figure 1C).
case_images: Emergency coronary angiography. (A) Muscle bridge and spasm in the middle segment of the LAD. (B) Right coronary artery.
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case_images: F2
case_images: Transthoracic echocardiography revealed a left ventricular ejection fraction of 67%, left atrium of 29 mm, left ventricle of 41 mm, interventricular septum of 11 mm, and right atrium of 36 x 28 mm.Emergency coronary angiography showed no left main coronary artery stenosis, myocardial bridge in the middle segment of LAD, moderate systolic lumen compression, TIMI3 blood flow, left circumflex artery(LCX) smooth patency, no plaque grade stenosis, TIMI3 blood flow, right coronary artery(RCA) smooth patency, no plaque grade stenosis, TIMI3 blood flow (Figure 2).