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Challenging case of J-wave syndromes
  1. Quan Minh Bui,
  2. Frederick Han,
  3. Bruno Cotter
  1. Division of Cardiovascular Medicine, Department of Medicine, University of California, San Diego, La Jolla, California, USA
  1. Correspondence to Dr Quan Minh Bui, Medicine, UCSD, La Jolla, CA 92037, USA; quan.minh.bui{at}gmail.com

https://doi.org/10.1136/heartjnl-2020-317494

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    Clinical introduction

    A 42-year-old man presented after accidental drug overdose complicated by out-of-hospital cardiac arrest. The patient underwent cardiopulmonary resuscitation with successful return of spontaneous circulation and was admitted to the intensive care unit for postcardiac arrest care, which included targeted temperature management (TTM). Urine toxicology screen was positive for cocaine. Initial ECG showed normal sinus rhythm at 84 bpm with incomplete right bundle branch block (RBBB) (figure 1A). During cooling to 33.7°C, ST-segment elevations were noted on the bedside monitor. Follow-up ECG showed sinus bradycardia at 44 bpm with incomplete RBBB, ST-elevations with superimposed J-waves and ‘saddleback appearance’, resembling type …

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    Footnotes

    • Twitter @QuanBuiMD

    • Contributors All authors contributed equally to this manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Patient consent for publication Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.