Dyspnoea with diffuse T wave inversion

A woman in her 50s presented with sudden onset severe chest tightness, shortness of breath, and surgical incision pain on the third day after thoracoscopic left upper lung lobectomy for lung cancer. She had not received chemotherapy or radiotherapy, and she had no family history of coronary artery disease or sudden death.On preoperative evaluation, her electrocardiogram (ECG) had been normal (fig 1). Her vital signs were as follows: temperature 36.0°C, heart rate 100 beats/min, respiration 18 breaths/min, blood pressure 112/74 mm Hg, and oxygen saturation 95% (when inhaling oxygen 3 L/min).bmj;378/sep15_4/e070894/F1F1f1Fig 1ECG on patient’s admission for surgeryWhen she presented with chest symptoms, physical examination found normal heart sounds and no pericardial friction rub. Breath sounds from the left lung were coarse and diminished, and no significant wet rales were heard. The patient underwent a second ECG (fig 2), coagulation tests, and tests for markers of myocardial injury.bmj;378/sep15_4/e070894/F2F2f2Fig 2ECG after the…
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