https://orcid.org/0000-0003-2760-9978
A 53-year-old man with rare thymic squamous cell carcinoma without myasthenia gravis had acute chest pain of 1-h duration. Highly sensitive troponin T values were not elevated initially and 6 h later. The 12-lead electrocardiogram revealed sinus tachycardia with diffuse ST-segment elevation and T-wave inversion (Panel A). Right lower lobe consolidation was present in the chest radiograph (Panel B). Emergent coronary angiography (Supplementary material online, Videos) revealed patent lumens of three coronary arteries and typical dynamic compression in the multiple segments of coronary arteries; no regional wall motion abnormalities were present on left ventriculography; intermittent square root sign, indicating pericardial constriction, was evident on pressure tracings (Panel C). Chest computed tomography revealed encasement of the mid-right coronary artery, mid- and distal left anterior descending artery, and obtuse marginal branches of the left circumflex artery (Panel D white arrows), likely causing the ST-segment elevations. He died 3 weeks after receiving hospice care.
Acknowledgements: The authors thank the Ministry of Science and Technology of the Republic of China, Taiwan for financial support of this research under contract MOST 109-2218-E-006-024.
Conflict of interest: The authors have submitted their declaration which can be found in the article Supplementary Material online.
