Figure 1 A-C: Serial ECG tracings; A. initial tracing was done on the presentation in the ICU showing an acute inferior (II, III, and aVF; red arrows) ST-segment elevation myocardial infarction (STEMI) and reciprocal ST-depression changes in leads (I, aVL, and V2-V5; blue arrows). B. tracing using V34 and V4R was done within 3 minutes of the above initial tracing. It is showing no right ventricular involvement. C. tracing was done within 20 minutes of the initiation of streptokinase IVI showing good resolution in the inferior ST-segment elevation with normalization of most reciprocal ST-depression changes in leads (I and V2-V5). There is a Wavy double sign or Yasser’s sign in I (lime and light blue arrows). and Wavy triple sign or Yasser’s sign-in II leads (lime, light blue, and red arrows).

Figure 1 D-F: D. tracing was done within 40 minutes of the initiation of streptokinase IVI and during the occurrence of involuntary movements showing reversible inferior (II, III, and aVF; red arrows) ST-segment elevation myocardial infarction (STEMI) and reciprocal ST-depression changes in leads (I, aVL, and V2-V5; lime arrows). E. tracing was done within 30 minutes after the cession of streptokinase IVI and after given anti-allergic showing slight improvement in the above inferior (II, III, and aVF; red arrows) ST-segment elevation myocardial infarction and reciprocal ST-depression changes in leads (I, aVL, and V2-V4; lime arrows). F. tracing was done within 9 hours after the above streptokinase IVI reaction and management showing nearly total improvement in the above inferior changes. There are evolutional T-wave inverted changes (pink arrows).

Figure 2 A- Chest CT without contrast was done within 5 days of the presentation showing bilateral patchy ground-glass pulmonary consolidation in the peripheral, basal, and posterior segments (lime arrows). There is mild to moderate basal pleural effusion (orange arrows). B- plain Chest XR film was done within 5 days of the presentation showing bilateral patchy ground-glass pulmonary consolidation (orange arrows).