PMC8458661_01
Left flank lesion.
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The presence of a single circular erythematous macular lesion was noted on the left flank. (Figure 1) Physical examination otherwise revealed no other abnormalities.
Electrocardiogram from admission showing normal sinus rhythm with slight ST-segment elevations in the inferolateral leads.
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Electrocardiogram (EKG) showed normal sinus rhythm with slight ST segment elevations in the inferolateral leads (Figure 2).
Doppler echocardiogram from admission showing an apical view with moderate-severe Mitral regurgitation.
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Echocardiogram was done which showed a left ventricular ejection fraction (LVEF) of 49% with mild diffuse hypokinesis, and moderate to severe mitral regurgitation (Figure 3).
Cardiac Magnetic Resonance Imaging (A) Axial view with red arrow showing nodular subepicardial enhancement and (B) Sagittal view with red arrow showing subepicardial enhancement that does not involve the endocardium.
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Agatston score of 0, and a left ventricular chamber size which was discerned to be at the upper limit of normal. A follow up cardiac magnetic resonance imaging(MRI) showed nodular subendocardial delayed enhancement in the nonvascular distribution which may represent myocarditis (Figure 4).