Published: 10 July 2018
Author(s): Takeshi Kondo
Issue: July 2018

A 74-year-old woman presented to our emergency department with acute chest pain. She had been diagnosed with depression two years earlier, for which she was taking antidepressants. Chest radiograph was normal. Electrocardiogram showed ST segment elevations and T wave inversions in the anterior leads (Fig. 1a). Blood tests revealed elevated levels of creatine kinase, brain natriuretic peptide, and troponin I. Echocardiography demonstrated left ventricular severe apical hypokinesis. While coronary angiography denoted no coronary artery disease, left ventriculography detected systolic apical ballooning with basal wall hyperkinesis (Fig.

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The specialty of internal medicine covers a wide range of conditions affecting the internal organs of the body. Although some diseases specifically affect individual organs, the majority of common diseases. The internist must then be trained to recognise and manage a broad range of diseases and, with the aging population, many patients with chronic and multiple disorders.

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