Article

Unmasking of J waves during right coronary angiography in patients with spontaneous coronary spasms and ventricular fibrillation.

Department of Cardiology, Tachikawa General Hospital, Japan.
Internal Medicine (impact factor: 0.94). 01/2012; 51(2):185-8. pp.185-8
Source: PubMed

ABSTRACT We encountered two consecutive cases with spontaneous ST elevation due to right coronary spasms and subsequent ventricular fibrillation (VF). Their 12-lead ECGs on anterior chest pain showed elevation of ST-segments in the inferior leads, but coronary angiography (CAG) revealed no significant stenosis. Both cases showed dramatically evolving J waves in the inferior leads during the right CAG, but it was not observed during angiography of the left CAG. Neither Brugada-type ECG nor long-QT was evident. In summary, J waves can be produced without ST-segment elevation, and contrast media-induced J waves might be related to the arrhythmogenesis of subsequent VF evoked by right coronary spasms.

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Keywords

12-lead ECGs
 
anterior chest pain
 
arrhythmogenesis
 
Brugada-type ECG
 
consecutive cases
 
contrast media-induced J waves
 
coronary angiography
 
coronary spasms
 
evolving J waves
 
J waves
 
significant stenosis
 
spontaneous ST elevation
 
ST-segments
 
subsequent ventricular fibrillation
 

Hitoshi Kitazawa