PMC5731616_01
Initial electrocardiogram with a right bundle branch block and diffuse T-wave inversions.
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Within 3 days of decreasing dosages of clonazepam and fluoxetine, she presented to the hospital with substernal chest pressure, a RBBB with T-wave inversions (Figure 1), as well as a peak troponin release (1.24 ng/mL, normal 0-0.5; peak creatine kinase MB of 15.2 ng/mL, normal 0-5; and B-type natriuretic peptide of 3028 pg/mL, normal 0-99) consistent with myocardial infarction and left ventricular dysfunction.
Echocardiogram, in systole, demonstrating apical hypokinesia in an apical 4-chamber view.
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An echo was performed which revealed anterior apical hypokinesia with an ejection fraction of 40% (Figure 2).
Coronary angiogram, in an RAO (right anterior oblique) projection, demonstrating a normal left anterior descending artery.
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A coronary catheterization was also performed which demonstrated normal coronaries (Figure 3).