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A 70-year-old Caucasian man presented at our chest pain unit due to progressive dyspnoea. Physical examination revealed an obese male with a quiet diastolic murmur. Cardiovascular risk factors were arterial hypertension, insulin-dependent diabetes mellitus and 70 pack-year smoking history. Inverted T waves were seen on ECG in I, V5, V6 and high sensitive troponin T (hsTnT) level was elevated (hsTnT max. 91 ng/L (cut-off <14 ng/L)). Urgent coronary angiography was performed and occlusive coronary artery disease was ruled out. Further examination by chest X-ray was unrevealing. Spirometry …
Contributors AP wrote the manuscript. JO performed transoesophageal echocardiography. TZ and MK supervised and revised the manuscript.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.