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

Intern Med. 2012;51(2):185-8. doi: 10.2169/internalmedicine.51.6343. Epub 2012 Jan 15.

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.

Publication types

  • Case Reports

MeSH terms

  • Coronary Angiography*
  • Coronary Vasospasm / complications
  • Coronary Vasospasm / diagnostic imaging*
  • Coronary Vasospasm / physiopathology*
  • Electrocardiography
  • Humans
  • Male
  • Middle Aged
  • Ventricular Fibrillation / complications
  • Ventricular Fibrillation / diagnostic imaging*
  • Ventricular Fibrillation / physiopathology*