PMC3272799_01
Sinus tachycardia, increase of T wave amplitude in leads V3 and V4 with 3 mm subsegment elevation ST.
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fig1
The second ICU ECG (Figure 1) showed sinus tachycardia, increase of T-wave amplitude in leads V3 and V4 with 3 mm elevation of the ST segment.
(a) Echocardiographically parasternal long axis depicted improvement of ventricle function. First echocardiogram obtained four days after admission showed LVEF of 48% (calculated by Simpson method). Hypokinesis of the septum and parietal wall of the left ventricle. (b) Second echocardiogram taken 24 days after BWS envenomation depicted good evolution of mitral regurgitation becomes grade I. LVEF was 50%.
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ICU hospitalization, the patient was extubated successfully. In the same day, his first serum concentration of troponin I was 1.93 ng/mL (N <= 0.01 ng/mL), and initial echocardiography (Figure 2(a)) demonstrated impaired left ventricle (LVEF 48%, calculated by Simpson method), with midventricular septum, anterolateral, and inferior walls hypokinesia. Two weeks after his discharge, echocardiography showed progressive improving LV function of 50% (Figure 2(b)) while the cardiac magnetic resonance imaging (MRI) showed normal-sized ventricles with mild hypokinesia of the LV (LVEF increased from 48% to 57%). T2-weighted imaging confirmed increased signal in the posterolateral wall of the basal LV indicative of hypokinesia (Figure 3).
Cardiovascular magnetic resonance T1-weighted sequence obtained two weeks after discharge showed hyperintensity of the posterior lateral wall of the basal left ventricle. LVEF was 57%.
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Two weeks after his discharge, echocardiography showed progressive improving LV function of 50% (Figure 2(b)) while the cardiac magnetic resonance imaging (MRI) showed normal-sized ventricles with mild hypokinesia of the LV (LVEF increased from 48% to 57%). T2-weighted imaging confirmed increased signal in the posterolateral wall of the basal LV indicative of hypokinesia (Figure 3).