PMC7467893_01
bedside chest radiograph; performed on day 1 showing cardiomegaly, pulmonary edema and small bilateral pulmonary effusions
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F1
The chest radiograph revealed para-hilar opacities and enlarged cardiac silhouette (Figure 1).
chest computed tomography: (A) obtained on day 1 shows substantial hilar congestion, cardiomegaly, and ground-glass changes; (B) obtained on discharge shows no significant abnormality
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F2
Chest Computed tomography showed ground-glass changes indicative of viral pneumonia (Figure 2A). After 13 days of hospitalization, the electrocardiogram, chest CT and echocardiography had become normal (Figure 2B, Figure 3B and Figure 4B).
electrocardiogram: (A) on day 1, shows sinus tachycardia at 125 beats/min diffuse and nonspecific disturbances of ventricular repolarization; (B) on discharge showing regression of disturbances of ventricular repolarization
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F3
The electrocardiogram revealed sinus tachycardia, diffuse and nonspecific disturbances of ventricular repolarization (Figure 3A). After 13 days of hospitalization, the electrocardiogram, chest CT and echocardiography had become normal (Figure 2B, Figure 3B and Figure 4B).
echocardiographic left ventricular M-mode images: (A) Day 1: LV diameter was enlarged, and the ejection fraction was decreased: (B) day 13: normal LVEF (60%) and wall thickness. LV = Left ventricle, LVE = left ventricle ejection fraction
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F4
Bedside transthoracic echocardiography revealed an enlarged left ventricle (61 mm) (Figure 4A), segmental myocardial hypokinesis along with a low left ventricular ejection fraction (LVEF) (30%) and elevated left ventricular pressures. After 13 days of hospitalization, the electrocardiogram, chest CT and echocardiography had become normal (Figure 2B, Figure 3B and Figure 4B).
coronary angiography; revealing no obstructive atherosclerosis lesions in the coronary arteries
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F5
Coronary angiography revealed no obstructive atherosclerosis lesions in the coronary artery (Figure 5).
MR imaging findings: (A) horizontal long axis true-FISP performed after gadolinium infusion demonstrated a subepicardial enhancement (arrows); (B) short-axis showing delayed-enhancement imaging (arrows). True-FISP = True Fat Imaging with steady-state precession
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F6
Day 6. Delayed enhancement sequences demonstrated subepicardial enhancement in the lateral free-wall of the left ventricle (Figure 6).