title: Unmasking of J waves during right coronary angiography in patients with spontaneous coronary spasms and ventricular fibrillation.
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.
authors.affiliation: Department of Cardiology, Tachikawa General Hospital, Japan. tatikawa@niigata-inet.or.jp
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kitazawa
authors.forename: Hirooki
authors.initials: H
authors.lastname: Matsushita
authors.forename: Masafumi
authors.initials: M
authors.lastname: Nakayama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Saito
authors.forename: Koichi
authors.initials: K
authors.lastname: Fuse
authors.forename: Satoru
authors.initials: S
authors.lastname: Fujita
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Minoru
authors.initials: M
authors.lastname: Takahashi
authors.forename: Masahito
authors.initials: M
authors.lastname: Sato
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
mesh_terms: D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D014693:Ventricular Fibrillation / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*