PMC8292064_01
(a) Initial ECG displaying ST-segment elevation in lead aVR and diffuse ST-segment depressions. (b) ECG after aggressive hydration displaying normalization of ischemic changes.
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fig1
The electrocardiogram (ECG) displayed an ST-segment elevation in lead aVR, along with global ST-segment depressions, most notably in the inferolateral leads (Figure 1(a)). Follow-up ECG demonstrated a complete resolution of the ischemic changes (Figure 1(b)), and the patient regained consciousness.
(a) RAO cranial LHC demonstrating significant middle-LAD stenosis during systole. (b) RAO cranial LHC demonstrating patent middle-LAD during diastole.
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fig2
An emergent left heart catheterization (LHC) revealed a smooth 99% filling defect at the middle segment of the left anterior descending artery (LAD) during systole (Figure 2(a)) that would rhythmically appear patent during diastole (Figure 2(b)), which was suggestive of myocardial bridging.