Manifestation of J wave induced by acetylcholine applied for a coronary spasm provocation test in a patient with aborted sudden cardiac death
oleh: Hiroyuki Kodama, MD, Kazumasa Fujita, MD, Shouhei Moriyama, MD, Kei Irie, MD, Hirotaka Noda, MD, Taku Yokoyama, MD, Mitsuhiro Fukata, MD, PhD, Takeshi Arita, MD, PhD, Keita Odashiro, MD, PhD, Toru Maruyama, MD, PhD, Koichi Akashi, MD, PhD
| Format: | Article |
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| Diterbitkan: | Wiley 2017-06-01 |
Deskripsi
A 51-year-old man with a resuscitation episode was referred to our hospital. Coronary angiography revealed a focal spasm overlapped with organic stenosis where a bare metal stent was implanted. Acetylcholine (ACh) provocation test did not induce chest pain. It revealed no discernible ST-T changes but unmasked a J wave at the end of the QRS complex, which was associated with short-coupled repetitive premature ventricular beats. A J wave reportedly appears immediately before the onset of ventricular fibrillation caused by vasospastic angina. However, a J wave observed newly after a coronary spasm provocation test using ACh without ST-T changes is informative when considering the mechanisms of the J wave.