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“Unstable angina” in a man aged 53 years
  1. Logan L Vincent,
  2. Selma D Carlson,
  3. Eric V Krieger
  1. Department of Medicine, Division of Cardiology, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Logan L Vincent, Department of Medicine, Division of Cardiology, University of Washington, Seattle 98195, USA; lvincent{at}

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Clinical introduction

A man aged 53 years presented to the emergency department with several hours of substernal chest pain radiating to his left arm. He had multiple myeloma treated with bortezomib, lenalidomide and dexamethasone. ECG showed inferior ST segment elevations. Troponin I was >73 ng/mL on hypersensitive troponin assay. Cardiac catheterisation was performed without obstructive coronary disease. Transthoracic echocardiogram showed normal left ventricular ejection fraction with abnormal global longitudinal strain of −10%. The patient developed ventricular tachycardia requiring electrical cardioversion. Repeat echocardiogram 48 hours later showed …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.

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