PMC8161849_01
Chest X-ray anteroposterior view demonstrating new diffuse bilateral airspace opacities (red arrows) (A) with comparison to chest X-ray performed 2 weeks prior (B).
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New diffuse bilateral airspace opacities indicating pulmonary infection were detected on chest X-ray in comparison to a one performed 2 weeks prior, when he presented to the emergency department with a mild cough and myalgia (Figure 1).
Electrocardiogram (ECG) demonstrating sinus rhythm and new ST elevation in the anterior and lateral leads (I, II, V2, V3, V4, V5, and V6) (red arrows) (B) compared with normal ECG from 2 weeks earlier (A). Subsequent ECG shows new ST elevation in lead aVF and worsening ST elevation in lead II (inferior leads) as well as worsening ST elevation in anterolateral leads (I, V3-V6), demonstrating diffuse ST elevation that is not confined to a single coronary territory (red arrows) (C).
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Electrocardiogram (ECG) demonstrated diffuse, mainly anterolateral, ST elevation (leads I, II, and V2-V6), markedly abnormal with new ischemic changes when compared with an ECG recorded 2 weeks prior (Figure 2A and B). II (inferior leads) as well as worsening ST elevation in anterolateral leads (I, V3-V6), demonstrating diffuse ST elevation that is not confined to a single coronary territory (Figure 2C). In addition, multiple episodes of ventricular tachycardia were observed on telemetry.
Coronary angiography demonstrating widely patent left (yellow arrowheads) (A, B) and right (red arrowheads) (C) coronary arteries, with no evidence for significant epicardial stenosis, thrombosis, or delayed emptying.
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The decision was then made to proceed to emergent LHC, and coronary angiography was performed, which unexpectedly revealed widely patent normal left and right coronary arteries, with no epicardial stenosis or thrombosis and no evidence for delayed coronary filling (Figure 3).