Vasospastic angina with J-wave pattern and polymorphic ventricular tachycardia effectively treated with quinidine

Ann Noninvasive Electrocardiol. 2012 Jul;17(3):286-90. doi: 10.1111/j.1542-474X.2012.00516.x.

Abstract

Background: Myocardial ischemia during coronary spasm may generate malignant ventricular arrhythmias. The J-wave pattern was suggested to be a marker of a disorder associated with life-threatening arrhythmias.

Results: We report the case of a patient with vasospastic angina and J-wave pattern in inferior and lateral leads associated with polymorphic ventricular tachycardia which was effectively treated only with quinidine-vasodilating drugs were not able to prevent the arrhythmia although they were effective in preventing ischemic events.

Conclusion: The J-wave pattern in inferolateral leads may be a sign of electrical vulnerability to lethal ventricular arrhythmia in patients suffering from vasospastic angina--quinidine can effectively prevent such arrhythmias in these patients.

Publication types

  • Case Reports

MeSH terms

  • Angina Pectoris, Variant / complications
  • Angina Pectoris, Variant / diagnosis
  • Angina Pectoris, Variant / therapy*
  • Atrial Fibrillation / diagnosis*
  • Atrial Fibrillation / etiology
  • Atrial Fibrillation / surgery
  • Atrial Flutter / diagnosis*
  • Atrial Flutter / etiology
  • Atrial Flutter / surgery
  • Catheter Ablation / methods
  • Combined Modality Therapy
  • Defibrillators, Implantable*
  • Drug Therapy, Combination
  • Electrocardiography / methods
  • Electrocardiography, Ambulatory / methods
  • Exercise Test / methods
  • Follow-Up Studies
  • Humans
  • Isosorbide / therapeutic use
  • Male
  • Middle Aged
  • Molsidomine / therapeutic use
  • Quinidine / therapeutic use*
  • Risk Assessment
  • Severity of Illness Index
  • Tachycardia, Ventricular / complications
  • Tachycardia, Ventricular / diagnosis
  • Tachycardia, Ventricular / therapy*
  • Treatment Outcome
  • Verapamil / therapeutic use

Substances

  • Verapamil
  • Molsidomine
  • Quinidine
  • Isosorbide