This case report highlights the utility of multimodality imaging in identifying the rare association between a single coronary artery and stress cardiomyopathy in a patient presenting with NSTEMI-like symptoms.
Case ReportA 58-years-old female patient was admitted with retrosternal chest pain described as a continuous, oppressive tightness that had started two days earlier, after a tooth extraction procedure performed under ineffective local anesthesia.The patient's past medical history included diabetes, dyslipidemia, and ovarian cancer, and she was receiving aspirin, rosuvastatin, metformin, dapagliflozin, and semaglutide.Physical examination was unremarkable.The chest pain protocol was initiated, and the initial electrocardiogram showed sinus rhythm with left anterior fascicular block, early repolarization in the inferior leads, and T-wave inversion in aVL, V1, and V2 (Figure 1A).The patient received 5 mg of sublingual isosorbide dinitrate, and blood samples were collected for laboratory testing.Highsensitivity troponin T (hs-cTnT) was 171 ng/L, confirming myocardial injury.An initial diagnosis of non-ST-elevation myocardial infarction (NSTEMI) was made, and the patient underwent coronary angiography (CA) for anatomic assessment (Figure 1 / Video S1).
Ferreira et al. (2026) studied this question.