A 68-year-old man presented with chest pain and presyncope. After that, he suffered from pulseless electrical activity (PEA) cardiac arrest. After he stabilized, a 12-lead ECG was performed (Cover image). In the following days, he had another PEA arrest, after which he was given CPR and thrombolytic therapy for STEMI. After spontaneous circulation was achieved, angiography was performed.
No disrupted plaque in arteries or significant stenosis could be observed. The left ventriculogram showed normal contraction without any left ventricular aneurysm, dissection, or mitral regurgitation. However, the patient complained of metabolic acidosis and depended on an intraaortic balloon pump despite the adequate cardiac output. Thus, a CT pulmonary angiogram was performed, which showed multiple segmental filling defects in the pulmonary arteries of the left lobe. What is your most likely…
