Osborn Waves Associated with Ventricular Fibrillation in a Patient with Vasospastic Angina

Maruyama, Mitsunori; Atarashi, Hirotsugu; T, Ino; Kuroda, Hiroshi

doi:10.1046/j.1540-8167.2002.00486.x

Cited by 62 publications

(36 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In most cases, acute myocardial ischemia induced prominent J waves with a merged steeply down-sloping ST segment in the inferior and/or lateral leads (9,11) which are very close to the ECG pattern as observed in Brugada syndrome: coved type ST elevation (1, 2, 11). Numerous ionic currents, calcium cycling, signal transduction, and so forth would be altered during the myocardial ischemia but, both channelopathy and ischemia may share common mechanisms which result in such prominent J waves and coved type ST elevation, which may be risk factors which develop into ventricular fibrillation due to phase 2 reentry (8,13,18,19).…”

Section: Discussionsupporting

confidence: 66%

“…Maruyama et al (9) reported a case of spastic angina pectoris in whom J waves (Osborn waves) developed during an ischemic attack. The amplitude of the Osborn waves increased spontaneously and this was followed by ventricular fibrillation.…”

Section: Discussionmentioning

confidence: 99%

“…Prominent J waves can be induced in some clinical settings which include acute myocardial ischemia (9)(10)(11)(12)(13). In this report, we describe a case with Brugada syndrome in whom prominent J waves and ST elevation were induced in the inferior and lateral leads during provoked coronary artery spasms.…”

Section: Introductionmentioning

confidence: 87%

See 2 more Smart Citations

Ischemia-Induced Prominent J Waves in a Patient with Brugada Syndrome

et al. 2010

View full text Add to dashboard Cite

A 75-year-old man was admitted to our hospital in January 2010 for evaluation of syncope and abnormal ECG. ECG showed type 1 ST elevation in lead V1 and he was diagnosed as Brugada syndrome. During cardiac catheterization, baseline coronary angiography was normal, but intracoronary ergonovine maleate induced spasms of the right and left coronary arteries concomitant with chest pain and ST elevation on ECG. J waves were accentuated or newly developed. Soon after an intracoronary injection of nitroglycerin, chest pain was relieved and ischemia-induced J wave disappeared and the ST segment returned to the same morphology as baseline. Extrastimuli induced ventricular fibrillation. He received an implantable cardioverter-defibrillator. He was also treated with Ca antagonist and isosorbide dinitrate and has had an uneventful course for 5 months.

show abstract

Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ischemia-Induced Prominent J Waves in a Patient with Brugada Syndrome

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Beyond hypothermia, other conditions have been reported to cause Osborn waves, such as hypercalcemia [7], brain injury [8], subarachnoid haemorrhage [9], cardiopulmonary arrest from oversedation [10], vasospastic angina [11], or idiopathic ventricular fibrillation [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

A Huge J Wave in Mild-Hypothermic Patient with Acute Brain Injury

Luzi¹,

Giada²,

Massimo³

et al. 2015

J Neurol Neurosci

View full text Add to dashboard Cite

The Osborn wave is a deflection immediately following the QRS complex of the surface ECG. It can be observed in hypothermic patients. A 51-year-old man was admitted to the emergency department of our hospital because of loss of consciousness with tonic-clonic seizures. The cranial computerized tomography (CT) showed intraparenchymal hematoma. After neurosurgical intervention, during hospitalization, the electrocardiogram (ECG) showed the presence of a huge Osborn wave.

show abstract

“…Osborn waves are most commonly observed in hypothermia (hypothermic hump). However, some other conditions including hypercalcaemia, damage to the brain, cardiac arrest, Chagas disease, ischaemic heart disease and Brugada syndrome have been reported to cause J waves [2,3]. Below a temperature of 30°C, the J waves are detectable in 80% of patients [4].…”

mentioning

confidence: 99%

J deflections on ECG in severe hypothermia and hypokalaemia: a case report

et al. 2011

View full text Add to dashboard Cite

The J wave, also known as Osborn wave, is a deflection that can be observed on the surface ECG as a late delta wave, seen at the end of the QRS complex. In this case, a 75-year-old woman, after 1 day of continuous haemodialysis, showed a marked hypothermia (28.5°C) and severe hypokalaemia (1.7 mEq/l). Bradycardia was seen on the monitor and J waves were recognised on the ECG recording. After appropriate replacement of potassium and treatment of hypothermia, the J waves disappeared spontaneously.Keywords J wave . Hypothermia . Hypokalaemia Hypothermia is generally defined as a core body temperature less than 35°C [1]. Hypothermia is classified as accidental or intentional and primary or secondary. Osborn waves are most commonly observed in hypothermia (hypothermic hump). However, some other conditions including hypercalcaemia, damage to the brain, cardiac arrest, Chagas disease, ischaemic heart disease and Brugada syndrome have been reported to cause J waves [2,3]. Below a temperature of 30°C, the J waves are detectable in 80% of patients [4]. Sinus bradycardia, prolonged PR and QT intervals or atrial fibrillation would be found in more profound hypothermia but all of these ECG abnormalities would normalise on re-warming [5]. Case reportA 75-year-old woman was admitted to our hospital with mechanical icterus and underwent percutaneous transhepatic cholangiography. There was no history of any cardiovascular disease. Electrocardiogram (ECG) on admission revealed normal sinus rhythm and left anterior hemiblock (Fig. 1). Haemodynamics were stable with a blood pressure of 120/70 mmHg and a heart rate of 88 beats/min. Physical examination was otherwise unremarkable. Unfortunately the patient's general condition deteriorated; she became anuric and she was intubated. Soon after intubation, haemodialysis was planned for the patient and after 1 day of continuous haemodialysis, the patient's body temperature was measured at 28.5°C and bradycardia was seen on the monitor. Figure 2 shows the patient's ECG recording at that time. Soon after the first recording, large QRS complexes were seen on the monitor and repeat ECG (Fig. 3) showed characteristic hypothermic humps, J waves, the QRS complexes became larger (200 msec) and the corrected QT interval reached 680 msec. A rightward axis shift was also seen. At that point a blood sample was taken and severe hypokalaemia (1.7 mEq/l) was observed. After appropriate treatment of hypothermia and hypokalaemia, the characteristic ECG findings disappeared, the main rhythm returned to normal sinus rhythm, the QRS narrowed (80 msec), and the corrected QT interval remained the same (680 msec). DiscussionThe J wave and elevated J point were described by Dr. John J. Osborn in 1953 [6], who worked on the use of hypothermia for cardiac surgery. The proposed cellular

show abstract

Osborn Waves Associated with Ventricular Fibrillation in a Patient with Vasospastic Angina

Cited by 62 publications

References 5 publications

Ischemia-Induced Prominent J Waves in a Patient with Brugada Syndrome

Ischemia-Induced Prominent J Waves in a Patient with Brugada Syndrome

A Huge J Wave in Mild-Hypothermic Patient with Acute Brain Injury

J deflections on ECG in severe hypothermia and hypokalaemia: a case report

Contact Info

Product

Resources

About