PMC4029766_01
The electrocardiogram shows ST-segment elevations in leads II, III, aVF, V1 to V4 with poor R-wave progression. The QTc was 531 ms.
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In the emergency department, an electrocardiogram was done, which revealed ST-segment elevations in leads II, III, aVF, and V1-V4 with poor R-wave progression (Figure 1).
Left ventriculogram shows evidence of apical ballooning typical of Takotsubo cardiomyopathy (red arrow).
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TCM with an ejection fraction of 40% (Figure 2). The left main artery was normal, and the left anterior descending, left circumflex, and right coronary arteries had mild disease (Figures 3 and 4).
Left coronary angiography with noncritical disease of the left anterior descending and left circumflex arteries.
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TCM with an ejection fraction of 40% (Figure 2). The left main artery was normal, and the left anterior descending, left circumflex, and right coronary arteries had mild disease (Figures 3 and 4).
Right coronary artery angiography with noncritical disease.
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TCM with an ejection fraction of 40% (Figure 2). The left main artery was normal, and the left anterior descending, left circumflex, and right coronary arteries had mild disease (Figures 3 and 4).
Echocardiography shows the left ventricle in diastolic phase (red arrows).
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An echocardiogram was performed, which revealed severe impairment of the middle and apical segments of the left ventricle, with an overall ejection fraction of 40-45%, and no evidence of intracavitary LV thrombus (Figures 5 and 6).
Echocardiography shows the left ventricle in systolic phase revealing severe dysfunction of the apex (red arrows) and hyperdynamic contraction of basal segments (green arrows).
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An echocardiogram was performed, which revealed severe impairment of the middle and apical segments of the left ventricle, with an overall ejection fraction of 40-45%, and no evidence of intracavitary LV thrombus (Figures 5 and 6).