PMC5869801_01
EKG showing ST-segment elevation on anteroseptal leads with reciprocal changes on inferolateral leads
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F1
T-wave inversions of the inferior leads with ST elevations in V1-V3 [Figure 1]. Troponin was elevated at 2.43, CPK 514, CK-MB 229, and BNP >5000 with lactic acid 2.1.
Two-chamber view with color Doppler showing severe eccentric mitral regurgitation Jet
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F2
Echo [Figures 2 and 3] demonstrates hypokinesis from the mid-anterior wall to the apex with systolic anterior motion (SAM) of the mitral valve and significant mitral regurgitation (MR).
Two-chamber view showing hypokinesis from mid anterior wall to apex
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F3
Echo [Figures 2 and 3] demonstrates hypokinesis from the mid-anterior wall to the apex with systolic anterior motion (SAM) of the mitral valve and significant mitral regurgitation (MR).
Left ventriculogram showing ventricular apical ballooning
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F4
Cardiac catheterization [Figure 4] demonstrated nonobstructive coronary artery disease of the left anterior descending (LAD) with an EF of 30%.
Pressure tracing during pull back showing the increased LVOT gradient
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F5
There was also an increased left ventricular outflow tract (LVOT) pressure gradient [Figure 5] secondary to SAM.
Chamber View showing resolution of apical ballooning and wall motion abnormalities
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F6
Repeat echo demonstrates EF of 65% with the resolution of apical ballooning and wall abnormalities [Figure 6].