PMC4369976_01
Electrocardiogram on Day 1.
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African-American postmenopausal woman presented to the hospital with a 1-h history of mild chest discomfort associated with nausea and diaphoresis. An electrocardiogram showed 2-mm inferoapical ST segment elevations (Fig. 1).
(A and B) Left anterior oblique cine angiographic view showing a large 'wrap-around' LAD with a long dissection extending from its mid (arrow) to distal segment.
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She was taken for urgent coronary angiography, which revealed a large 'wrap-around' left anterior descending artery (LAD) with a long dissection extending from its mid to distal vessel (Fig. 2) without any atherosclerotic changes in the right or left coronary arteries.
Electrocardiogram on Day 6.
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An electrocardiogram prior to discharge revealed persistent ST elevation in the previously involved leads (Fig. 3), whereas her echocardiogram showed akinesis in the apical region with an ejection fraction of 61%.