Article Text

Download PDFPDF

A 69-year-old woman with extended negative T wave
  1. Keiji Matsunaga,
  2. Takahisa Noma,
  3. Tetsuo Minamino
  1. Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine Kagawa University, Kida-gun, Kagawa, Japan
  1. Correspondence to Dr Tetsuo Minamino, Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kida-gun, Kagawa, Japan; minamino{at}


Clinical Introduction A 69-year-old woman with hypertension and dyslipidemia developed sudden onset of substernal chest pain at night and was admitted to our hospital the following day. A 12-lead and 18-lead ECG (Nihon Kohden, Japan) was done (figure 1A,B).

Figure 1

(A) Twelve-lead ECG. (B) Eighteen-lead ECG.

Which is the most likely diagnosis?

  1. Reperfused anterior acute myocardial infarction

  2. Takotsubo (stressed) cardiomyopathy

  3. Pericarditis

  4. Apical hypertrophic cardiomyopathy

Which is the most likely diagnosis?For answer see page 2.

  • ECG
  • cardiac care, diagnosis
  • cardiac care, acute coronary syndrome
  • ECG, methods

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors All authors have contributed to the conception of the paper and the interpretation of the data.

  • 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.

  • Patient consent for publication Not required.

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

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.