Variant Angina with Spontaneously Documented Ischemia- and Tachycardia-induced "Lambda" Waves.

In a patient with variant angina of the proximal left anterior descending coronary artery, myocardial ischemia changed the QRS-ST-T configurations without J-waves into those resembling "lambda" waves at maximal ST-segment elevation, and couplets or triplets of supraventricular extrasystole (SVE) changed the ischemia-induced "lambda" waves into QRS-ST-T configurations resembling a "tombstone" morphology or "monophasic QRS-ST complex." At the resolution phase of coronary spasm, the QRS-ST-T configurations returned to those without J-waves and were changed by SVE into "lambda" waves. Interestingly, neither ischemia- nor SVE-induced "lambda" waves or SVE-induced "tombstone" morphology or "monophasic QRS-ST complex" were complicated by ventricular tachyarrhythmia.

Citation

Koji Takahashi, Tomoki Sakaue, Mina Yamashita, Daijiro Enomoto, Shigeki Uemura, Takafumi Okura, Shuntaro Ikeda, Nobuhisa Yamamura, Kaori Ikeda. Variant Angina with Spontaneously Documented Ischemia- and Tachycardia-induced "Lambda" Waves. Internal medicine (Tokyo, Japan). 2021;60(9):1409-1415

Mesh Tags

PMID: 33952813

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