PMC5353442_01
Electrocardiogram on second day post-right craniotomy for evacuation of hemorrhage and clipping of right middle cerebral artery aneurysm showing deep negative T waves in almost all leads with prolonged QTc interval (580 ms)
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ECG on the second day showed deep negative T waves in almost all leads with prolonged QTc interval [Figure 1].
Two-dimensional transthoracic echocardiography in the apical four-chamber view showing the left ventricle a) at end diastole and b) mid-systole. Basal and apical segments contract well in contrast to midventricular segments
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Due to abnormal myocardial necrosis markers and ECG, a two-dimensional (2D) transthoracic echocardiogram was ordered, and revealed a normal left ventricular cavity size with hyperdynamic basal motion, akinesis of midventricular segments and nearly normal apical motion [Figure 2].
Left ventriculogram showing systolic anterior wall aneurysm
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However, the ventriculogram surprisingly revealed an aneurysmatic anterior wall [Figure 3], which then was characterized by another transthoracic echocardiogram as an anteroseptal wall aneurysm with near-normal motion of the other segments [Figure 4].
Two-dimensional transthoracic echocardiography in the apical long-axis view showing anteroseptal wall aneurysm with nearly normal motion of the other segments in a) end diastole and b) mid-systole
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However, the ventriculogram surprisingly revealed an aneurysmatic anterior wall [Figure 3], which then was characterized by another transthoracic echocardiogram as an anteroseptal wall aneurysm with near-normal motion of the other segments [Figure 4].
Two-dimensional (2D) transthoracic echocardiogram in the apical long-axis view showing complete resolution of wall motion abnormalities at a) end diastole and b) mid-systole. c) shows radial strain of midventricular segments. On the left, a short-axis view of the mid-left ventricle is shown, and a 2D speckle tracking technique is used to obtain the curves representing radial deformation of each wall segment (right). The averaged global strain is 57% (represented by white curve)
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