PMC4677587_01
Chest X-ray showing no active disease.
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F0001
Chest X-ray on admission was normal (Fig. 1).
Admission electrocardiogram showing sinus tachycardia and non-specific T-wave abnormality.
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F0002
T-wave abnormality (Fig. 2). The following day, the patient became tachycardic, agitated, and confused with auditory and visual hallucinations, delusions, tactile disturbances with a Clinical Institute Withdrawal Assessment of Alcohol
Electrocardiogram showing ventricular tachycardia.
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F0003
Cardiac monitoring in the intensive care unit and a 12-lead ECG revealed episodes of non-sustained monomorphic ventricular tachycardia (Fig. 3).
Chest X-ray showing pulmonary vascular congestion.
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F0004
Chest X-ray obtained at this time was suggestive of pulmonary edema (Fig. 4).
Electrocardiogram showing diffuse ST-segment elevation.
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F0005
A repeat ECG few hours later showed diffused ST elevation (Fig. 5), and a bedside echocardiogram revealed left ventricular dilatation with apical ballooning on systole with a left ventricular ejection fraction of 20-25% and normal pulmonary artery pressures (Fig. 6).
Repeat chest X-ray with improved lung aeration.
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F0007
Significant clinical and radiological improvement (Fig. 7) leading to subsequent extubation was observed over the next few days.
(a, b) Coronary angiogram showing no significant coronary artery disease.
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F0008
ST-T wave changes resolved. She subsequently underwent cardiac catheterization, which revealed no significant coronary artery disease (Fig. 8a and b).