Transient Giant R Wave as a Marker for Ischemia in Unstable Angina

Chugh, Yashasvi; Maraboto, Carola; Christia, Panagiota; Faillace, Robert T.

doi:10.7759/cureus.1200

Cited by 1 publication

(1 citation statement)

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“…Giant R waves, defined as a 50% or greater increase in R wave amplitude [ 10 ], develop particularly during myocardial ischemia [ 11 , 12 ]. However, this waveform has not been reported during hypothermia to date.…”

Section: Introductionmentioning

confidence: 99%

Accidental Hypothermia-Induced J Wave Coupled With Giant R Wave Augmented by Premature Atrial Contraction: A Case Report

Takahashi,

Morioka,

Uemura

et al. 2024

Cureus

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The 12-lead electrocardiographic findings in hypothermia include the presence of J waves; prolongation of the PR, QRS, and QT intervals; and atrial and ventricular dysrhythmias. Among these findings, the J wave, known as the Osborn wave, is considered pathognomonic. In 1953, the J wave was reported as a specific response to hypothermia in dogs, representing the current at the site of injury instead of a widening of the QRS complex that occurs caused by a conduction delay. The J wave is often accompanied by ventricular fibrillation. For the past 28 years, it was assumed that the hypothermia-induced J wave was mediated by the transient outward current. However, it was recently been reported that the J waves in some patients with hypothermia can be considered delayed conduction-related waveforms. Here, we present a case of hypothermia-induced J waves together with giant R waves, which have not been previously reported during hypothermia, augmented by short RR intervals arising from premature atrial contractions. Our observations indicate that the underlying mechanism for the genesis of J waves is indeed conduction delay and not transient outward currents.

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Section: Introductionmentioning

confidence: 99%