1Department of Clinical Laboratory, Social Welfare Corporation Hokkaido Social Work Association Obihiro Hospital (Obihiro Kyoukai Hospital), 2Second Department of Internal Medicine, Social Welfare Corporation Hokkaido Social Work Association Obihiro Hospital (Obihiro Kyoukai Hospital)
A 63-year-old man was admitted to our hospital complaining of strong chest pain in the early morning. His medical history included percutaneous coronary intervention (PCI) resulting from anterior myocardial infarction. The electrocardiogram showed significant change only in the right bundle branch block. No troponin T or enzymes derived from the myocardium were detected. The echocardiogram showed anteroseptal akinesis. Wall motion abnormality improved 4 minutes after the initial scan, but appeared again 14 minutes later. Diastolic stunning and postsystolic shortening were detected by two-dimensional speckle tracking analysis at 4 and 14 minutes, respectively. Percutaneous coronary intervention was performed immediately when coronary angiography indicated 90% stenosis in a stent implanted in the left anterior descending artery. We report this as a rare case of acute coronary syndrome with myocardial wall motion which changed remarkably under echocardiographic observation.