Laboratory investigations Investigation Result Hemoglobin level (gm/L) 84 White blood cell count (x109 cells/L) 91.8 Differential count (N/L/M/E) 82/10/04/03 Platelet counts (x109/L) 142 ESR (mm in the 1st hour) 79 CRP (mg/L) (N < 6) 86 Tuberculin skin test 0 mm Blood culture Urine culture Sterile Sterile Serum Widal titers Non-reactive IgM EBV-VCA Non-reactive HIV serology Non-reactive HBsAg, Anti-HCV Non-reactive VDRL test Non-reactive 2-dimensional echocardiography
Normal CRP: C-reactive protein; EBV-VCA: Epstein Barr Virus-viral capsid antigen; ESR: erythrocyte sedimentation rate; HBsAg: hepatitis B surface antigen; HCV: hepatitis C virus; HIV: human immunodeficiency virus; N/L/M/E: neutrophils/lymphocytes/monocytes/eosinophils; VDRL: venereal disease research laboratory
We preferred the area above the right ventricle to measure EAT thickness, because this area is known to have the thickest EAT layer.7 Epicardial fat thickness, identified as an echo-free space between the pericardial layers on 2-dimensional echocardiography
, was measured perpendicularly in front of the right ventricular free wall at end-diastole.14,15
Scott, "Left ventricular false tendons in children: prevalence as detected by 2-dimensional echocardiography
and clinical significance," The American Journal of Cardiology, vol.
Transthoracic 2-dimensional echocardiography
did not identify lesions.
Nakamura, "A case of lipomatous hypertrophy of the interatrial septum detected via transthoracic 2-dimensional echocardiography
," Journal of Clinical Ultrasound, vol.
revealed large secundum defect with adequate all rim except deficient aortic rim.
has revolutionized the diagnosis and management of cardiac malformations.
EAT, identified as an echo-free space between the myocardium and visceral pericardium on 2-dimensional echocardiography
, was measured perpendicularly in front of the right ventricular free wall at end-diastole (16, 34).
Cardiac morphology and function were assessed by 2-dimensional echocardiography
, or cardiac catheterization when needed.
Electrocardiogram and 2-dimensional echocardiography
of the heart were normal (not shown).
All participants were in sinus rhythm, had stable and clinically confirmed heart failure, and had a left ventricular ejection fraction of less than 45% as determined by radionuclide, contrast angiography, or 2-dimensional echocardiography
To our knowledge, our report represents the second report in the literature of energy drinks precipitating an episode of STEMI that also underwent invasive angiography with no evidence for coronary obstruction  and the only report that evaluated the pattern of myocardial abnormality of energy drink-induced STEMI using noninvasive imaging modalities of 2-dimensional echocardiography
, longitudinal strain, and cMRI.