PMC5866903_01
12-lead EKG showing ST elevation and Q waves in leads II, III, and aVF and sinus rhythm with first-degree AV block.
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A routine 12-lead EKG was performed on admission which showed ST elevation in inferior leads with Q waves and sinus rhythm with first-degree AV block (Figure 1) with troponin-I levels of 38.22 ng/dl, suggestive of a recent age indeterminate inferior wall ST elevation myocardial infarction.
Coronary angiography showing 100% occlusion of the mid-right coronary artery.
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After the resolution of sepsis and acute kidney injury, diagnostic cardiac catheterization was performed which showed 100% mid-right coronary artery (RCA) occlusion (Figure 2), inferior wall akinesis, and 80% mid-left anterior descending (LAD) lesion (Figure 3), and ischemic cardiomyopathy was confirmed.
Coronary angiography showing 80% occlusion of the left anterior descending artery.
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fig3
After the resolution of sepsis and acute kidney injury, diagnostic cardiac catheterization was performed which showed 100% mid-right coronary artery (RCA) occlusion (Figure 2), inferior wall akinesis, and 80% mid-left anterior descending (LAD) lesion (Figure 3), and ischemic cardiomyopathy was confirmed.
Nuclear regadenoson stress test showing inferoseptal wall defect.
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A nuclear regadenoson stress test was performed which showed large inferoseptal wall defect with akinesia and surrounding anteroseptal wall hypokinesia (Figure 4).