PMC9251079_01
ECG (a): ECG on presentation. Sinus tachycardia with biatrial enlargement, rightward axis deviation, and septal infarction of indeterminate age with diffuse ST segment depressions in leads II, III, aVF, and V3-V6. ECG (b): repeat ECG, 6 hours after admission. Normal sinus rhythm with a prolonged QTc of 631.
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While in the emergency department, the ECG showed anteroseptal ST-elevations (Figure 1) and the initial troponin was 1.10 ng/mL. The troponin on 12-hour recheck was 1.51 ng/mL Also, her repeat ECG performed 6 hours after admission as well had subsequently changed from anteroseptal ST-segment elevations to normal sinus rhythm with no ST-segment elevations or depressions (Figure 1).
(a) Systole and (b) diastole: transthoracic echocardiogram: left ventricular ejection fraction of 25-30% with reduced systolic function. Akinesis of the basal-mid anteroseptal wall and hypokinesis of the entire inferior wall.
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fig2
Additionally, the left ventricle was noted to have akinesis of the basal-mid anteroseptal walls and hypokinesis of the inferior wall (Figure 2).
CTA of the coronary vessels demonstrates a patient left main and proximal segment of the left anterior descending branching off of the aorta.
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No abnormalities of the coronary vessels were identified (Figure 3).