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case_images: The dynamic changes of electrocardiogram and chest radiograph. (A) Electrocardiogram (ECG) showed QS complex only in V1-V3 leads and 1-2 mm ST-segment depression in II, III, aVF, V4-V6 leads on April 13th. (B) Chest radiograph showed bilateral pulmonary scattered inflammatory changes and possible pulmonary on April 13th. (C) Discordant terminal negative T waves in leads V1-V6 was observed in ECG on April 18th. (D) Chest radiograph showed no pulmonary congestion and obvious inflammation on April 19th.
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case_images: ECG showed QS complex only in V1-V3 leads and 1-2 mm ST-segment depression in II, III, aVF, V4-V6 leads (Figure 1A). Chest radiograph showed bilateral pulmonary scattered inflammatory changes and possible pulmonary oedema after IABP implantation (Figure 1B). After a period of treatment, the ECG findings on April 18th revealed flat or inverted T waves in leads V1-V6 (Figure 1C). On April 19th, chest radiograph showed no signs of pulmonary congestion or inflammation (Figure 1D). 
case_images: The transthoracic echocardiography (TTE). (A) TTE on April 13th revealed severely impaired movement of the ventricular wall (left ventricular end diastolic diameter (LVEDD), 47.3 mm; interventricular septum thickness (IVS), 8.4 mm; left ventricular ejection fraction (LVEF), 35.7%; left ventricular fraction shortening (LVFS), 17.1%; stroke volume, 37.1 mL), moderate to severe regurgitation of the mitral valve and tricuspid valve (the estimated pulmonary artery systolic blood pressure was 49 mmHg) and deteriorated diastolic function (E/E', 9.1) as well as a moderately reduced right ventricular function [tricuspid annular plane systolic excursion (TAPSE), 12 mm]. The inferior vena cava was widened (inferior vena cava diameter, 22.3 mm]) and its' respiratory collapse rate was less than 50%. (B) TTE on April 14th still showed decreased myocardial contractility (LVEDD, 51.9 mm; IVS, 8.0 mm; LVEF, 36.6%; LVFS, 17.7%; stroke volume, 47.3 mL), severe regurgitation of the mitral valve and deteriorated diastolic function (E/A, 3.3; E/E', 21.5) as well as a moderately reduced right ventricular function. The respiratory collapse rate of inferior vena cava (diameter, 17.2 mm) was less than 50%. (C) TTE on April 21th revealed a normalized cardiac function (LVEDD, 42.5 mm; IVS, 10.5 mm; LVEF, 50.8%; LVFS, 30.3%; stroke volume, 46.9 mL), moderate regurgitation of the mitral valve and restored diastolic function (E/A, 1.8; E/E', 9.7) without reduced right ventricular function.
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case_images: The transthoracic echocardiography (TTE) revealed a severely impaired left ventricular ejection fraction (LVEF ~35.7%), a moderately reduced right ventricular function [tricuspid annular plane systolic excursion (TAPSE) =12 mm)], moderate to severe regurgitation of the mitral valve and tricuspid valve (the estimated pulmonary artery systolic blood pressure was 49 mmHg) (Figure 2A). On the first day following the initiation of IABP (Counterpulsation pressure: 110 mmHg) and VA-ECMO (Rotation speed: 3495 RPM/min; Flow: 2.62 L/min), TTE still indicated a decrease in myocardial contractility, with an LVEF of 36.6% (Figure 2B). Eight days after she was admitted, TTE revealed that the patient had a normalized cardiac function with no sign of persisting heart failure (left ventricular end diastolic diameter (LVEDD), 42.5 mm; interventricular septum thickness (IVS), 10.5 mm; LVEF, 50.8%) (Figure 2C).
case_images: The Coronary angiography. Coronary angiography revealed that there was no stenosis or obstructive lesions in the coronary artery April 13th.
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case_images: Coronary angiography revealed no artery stenosis in hospital day one (Figure 3).
case_images: The lung and abdominal computerized tomography. (A) Lung computerized tomography showed scattered streaks in the right lower lung April 21th. (B) Full abdominal computerized tomography scan revealed that colorectal dilatation, which need being ware of paralytic intestinal obstruction April 24th.
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case_images: On the eighth day of hospitalization, a lung CT scan exhibited dispersed streaks in the lower right lung (Figure 4A), prompting a modification in the antibiotic regimen to piperacillin sulbactam (4.5g intravenous every eight hours). Subsequently, on the eleventh day of hospitalization, a comprehensive abdominal CT scan revealed colorectal dilatation, necessitating heightened awareness for the possibility of paralytic intestinal obstruction (Figure 4B).
case_images: The timeline following the clinical treatment of the patient. The main treatment measures of the patients were clearly listed in chronological order.
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case_images: Figure 5. Follow-up for seven month after discharge showed the patient had no chest tightness and shortness of breath after activity and the cardiac function was maintained at grade I (New York Heart Association classification system).