PMC3923566_01
Echocardiogram obtained at the time of admission.
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F1
The echocardiogram, which was performed when the patient was pain-free, revealed normal ventricular volume, no segmentary wall hypokinesia with a left ventricular ejection fraction of 72%, normal diastolic heart function, normal valve flow and absence of pericardial effusion (Figure 1).
Electrocardiogram taken during the anginal episode in the coronary intensive care unit. Sinus bradycardia (50 beats per minute (bpm)) with diffuse ST-segment elevation (arrows) in the anterior leads (V3 to V6) and inferolateral leads (I, II, III, augmented vector left and augmented vector foot) and peaked T-waves (dots) at the same leads are suggestive of transmural ischemia.
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F2
A new ECG was taken immediately and revealed sinus bradycardia (50bpm) with diffuse ST-segment elevation in the anterior leads (V3 to V6) and inferolateral leads (I, II, III, augmented vector left (aVL) and augmented vector foot (aVF)) and peaked T-waves at the same leads (Figure 2), suggestive of transmural ischemia.
Electrocardiogram taken 20 minutes after the patient's pain resolved. Arrows show progressive recovery of ventricular repolarization abnormalities.
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F3
The ECG that was taken 40 minutes afterward showed progressive recovery of ventricular repolarization abnormalities (Figure 3).
Coronary angiography images showing normal epicardial coronary artery tree and normal left ventricular function.
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F4
CTnI, remained within the normal range. Coronary and ventricular angiography performed 48 hours later revealed a normal epicardial coronary artery tree and normal left ventricular function (Figure 4).