PMC3601249_01
Left and right coronary artery (a
 top), cardiac ventriculography at diastole at systole (a
 lower), left ventricular average global longitudinal peak systolic strain (GLPS) at acute phase (b), cardiac magnetic resonance T2-weighted sequence (c), cardiac magnetic resonance delayed post-contrast hyperenhancement imaging (d), follow-up left ventricle GLPS (e)
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Fig1
With subsequent diagnosis of acute coronary syndrome, the patient was referred for urgent coronary angiography, which documented no coronary artery disease (Fig. 1a top). Ventriculography revealed an apical ballooning pattern with contrast retention in the apex (Fig. 1a lower). Bedside echocardiogram revealed akinesis of apical and midventricular segments of left ventricle with ejection fraction (LVEF) of 30 % and diminished average global longitudinal peak systolic strain (GLPS -10.3 %) (Fig. 1b). Cardiac magnetic resonance T2-weighted sequence did not record any pathological regional increase of the myocardial signal intensity (Fig. 1c); delayed postcontrast hyperenhancement was absent, consistent with viable myocardium (Fig. 1D).