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Electrocardiographic J waves as a hyperacute sign of Takotsubo syndrome.

Research paper by Alessandro A Zorzi, Federico F Migliore, Martina M Perazzolo Marra, Giuseppe G Tarantini, Sabino S Iliceto, Domenico D Corrado

Indexed on: 15 May '12Published on: 15 May '12Published in: Journal of Electrocardiology



Abstract

Typical electrocardiographic (ECG) signs of acute Takotsubo syndrome (TTS) consist of ST-segment elevation and/or T wave inversion. We report an unusual case of a 62-year-old woman with TTS who acutely exhibited on 12-lead ECG transient J waves preceding ST-T abnormalities. In the experimental model of myocardial ischemia, the appearance of J waves represents an early ECG abnormality and is followed by ST-segment elevation. Because of the similar ECG time course observed in TTS and myocardial ischemia, we speculate that common electrophysiologic mechanisms may account for J waves appearance in these 2 clinical conditions. Our case report shows that recording of ECG J waves in postmenopausal women presenting for acute chest pain may be a sign of an ongoing TTS and suggests a similarity to myocardial ischemia as the pathologic basis.