PMC6740047_01
Index presentation electrocardiogram (ECG). There is marked 5- to 6-mm convex ST-segment elevation in the inferior leads of II, II and aVF (left-sided arrows) with ST depression in leads V1-V2, suggestive of an inferoposterior myocardial infarction. Additionally, there is similar ST-segment elevation in leads V4-V6 (right-sided arrows box), suggestive of an anterolateral myocardial infarction. Overall, the ECG displays a diffusely ischemic picture typically reflected in left main or multivessel coronary artery disease.
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An emergent 12-lead electrocardiogram indicated a sinus tachycardia with marked 5- to 6-mm, convex ST-segment elevation in both the inferior (II, III, and aVF) and anterolateral (V4-V6) leads (see Figure 1).
Cineangiography series of the left coronary artery (LCA). (a) Right anterior oblique (RAO) angiographic view of the left anterior descending (LAD) artery with the white arrows subtending the type 2A pregnancy-associated spontaneous coronary artery dissection (PASCAD). (b) "Steep" RAO angiographic view of the LAD artery with the white arrows subtending the type 2A PASCAD. (c) Straight cranial view of the LAD artery with the white arrows subtending the type 2A PASCAD.
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Angiography revealed a diffuse, mid to transapical LAD artery type II A SCAD pattern (see Figure 2) as well as a proximal posterior left ventricular branch of the RCA type II A SCAD pattern (see Figure 3).
Cineangiography series of the right coronary artery (RCA). (a) Left anterior oblique angiographic view of the RCA with the white arrow indicating the type 2A pregnancy-associated spontaneous coronary artery dissection (PASCAD). (b) Right anterior oblique angiographic view of the RCA artery with the white arrow indicating the type 2A PASCAD.
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Angiography revealed a diffuse, mid to transapical LAD artery type II A SCAD pattern (see Figure 2) as well as a proximal posterior left ventricular branch of the RCA type II A SCAD pattern (see Figure 3).