PMC3891160_01
The initial ECG shows 3 mmV ST elevation in V2,3,4 (A). The 1 day follow-up ECG shows decreased ST elevation in V2,3,4 (B).
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F1
On the initial electrocardiogram, 3 mm ST segment elevation in leads V2 through V4 and Q wave in lead II, III, and aVF was observed (Figure 1A).
On admission day, there is no active lung lesion in the chest PA (A). On the 7th hospital day, there is pulmonary congestion (B).
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F2
The chest X-ray revealed no abnormalities (Figure 2A). The chest radiograph revealed pulmonary congestion on both sides (Figure 2B).
The baseline coronary angiogram shows 70% stenosis at the proximal and 90% stenosis at the mid portion of the left anterior descending artery (A) and no residual stenosis is present after successful percutaneous coronary intervention with stent implantation (B).
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F3
Ninety percent stenosis on the 2nd obtuse marginal branch was also observed (Figure 3A). PCI with stent implantation for LAD lesions was successful (Figure 3B).
Transthoracic Doppler echocardiography reveals a 1.3 cm sized ventricular septal defect at the cardiac apex, and a turbulent shunt flow from the left ventricle (LV) to the right ventricle (RV) through the interventricular septal defect.
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F4
Echocardiography revealed improved wall motion of the anterior wall and the cardiac apex, but a ventricular septal defect approximately 1.3 cm in diameter was observed at the apical septum (Figure 4).