PMC8733163_01
(A) Initial electrocardiogram on admission showed ST segment elevation in the inferior leads II, III, and aVF (red arrows) and posterior wall (blue arrows). (B) a dynamic ECG pattern was also observed on the second after admission.
fcvm-08-741253-g0001.jpg
PMC8733163_01_fcvm-08-741253-g0001.jpg
F1
II, III, and aVF, reciprocal depression in leads V1-4 and elevation in posterior leads. In addition, a dynamic ECG pattern was also observed on the second after admission (Figure 1B).
Abdominal CT on admission showed acute pancreatitis with peripancreatic exudation (red arrows).
fcvm-08-741253-g0002.jpg
PMC8733163_01_fcvm-08-741253-g0002.jpg
F2
Repeated abdominal CT (Figure 2) combined with the marked elevation of serum amylase (886 U/L, reference range, 35-135 U/L) and lipase (3,451 U/L, reference range, 23-300 U/L) in our hospital indicated a definitive diagnosis of acute pancreatitis and multiple atherosclerosis.
Coronary computed tomography angiography indicated critical stenosis (red arrows) of right coronary artery and left anterior descending coronary artery.
fcvm-08-741253-g0003.jpg
PMC8733163_01_fcvm-08-741253-g0003.jpg
F3
T was 6.910 ng/mL (reference range, 0-0.014 ng/mL). CCTA (Figure 3) was performed after informed consent was obtained, which indicated severe stenosis with non-calcified plaques of multiple coronary arteries, including the third segment of right coronary artery and the sixth and seventh segments of left anterior descending artery. Therefore, acute inferior myocardial infarction was definitively diagnosed.