PMC6467034_01
(A) Baseline CT scan shows multiple cavitatory nodules (white arrowheads). (B) Air density is seen in the ascending aorta (black arrow) and at the right coronary ostium (black arrowhead). There is minimal pneumothorax (star). (C) Air density is seen along the course of the right coronary artery (black arrowhead). (D) The tip of the lung biopsy needle is seen within the lung but away from the nodule. Air density is seen in the ascending aorta (black arrow) and along the course of the right coronary artery (black arrowhead)
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F1
CT chest revealed three cavitating lung nodules in the right lung without significant lymphadenopathy or pleural effusion [Figure 1A]. However, air density was seen in the ascending and descending aorta, and in the right coronary artery [Figure 1B-D].
Serial ECGs reveal complete heart block and S-T segment elevation in inferior leads just after the onset of symptoms followed by gradual normalization
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F2
ECG revealed ST segment elevation in the inferior leads with reciprocal changes in the lateral leads and complete heart block [Figure 2].
Right coronary angiogram reveals normal opacification of the right coronary artery and its branches without any filling defect
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F3
The patient underwent immediate cardiac catheterization angiography (with a time gap of 50 min between the onset of symptoms and first angiographic shoot) [Figure 3].