LAUSR

An 86-year-old woman with a history of hypertension and diabetes presented with left-sided chest pain and dyspnoea 2 weeks after her treatment for diffuse large B-cell lymphoma. She was treated with a chemo-free regimen with intravenous rituximab 375 mg/m2, and oral lenalidomide 15 mg 5 days/week for 3 weeks before admission.1 On admission, her 12-lead ECG showed sinus bradycardia and 1 mm ST segment elevation over lead III and aVF (figure 1). Bedside echocardiogram showed left ventricular (LV) ejection fraction (LVEF) of 50% with inferior wall hypokinesia. Her first serum troponin T (TnT) level was markedly elevated to 4239 ng/L (figure 1). Therefore, she was initially diagnosed to have inferolateral ST segment elevated myocardial infarction (MI). Urgent cardiac catheterisation was performed which showed normal coronary arteries but marked hypokinesia at the inferior wall on left ventriculogram. …