Exercise-induced vasospasm and the J-wave syndrome

摘要

We report the case of a 63-year-old man with multiple cardiovascular risk factors who underwent stent implantation in proximal left anterior descending coronary artery in August 2008 because of unstable angina and 1-vessel disease. Two years later, the patient was referred again to our department because of symptoms of exercise-induced typical angina pec-toris. Repeated coronary angiography revealed stent stenosis that was treated with a drug-eluting stent involving ostium and proximal left anterior descending coronary artery, and the patient was discharged on medical therapy. In July 2010, he presented atypical episodes of chest pain and a bicycle exercise test (World Health Organization protocol) was performed on admission. After normal baseline electrocardiographic (ECG) recording, a clear generalized J wave (arrowheads) progressively developed at 6 minutes of exercise (100 W).