Related Experiment Videos
Transient giant R-wave, right axis deviation, and intraventricular conduction delay during exercise treadmill
Man-Hong Jim1, Chung-Wah Siu, Stephen Wai-Luen Lee
1Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong. jimmanh2002@yahoo.com
Journal of Electrocardiology
|May 11, 2004
Summary
A patient with chest pain and a unique ECG pattern, diagnosed as giant R-wave syndrome, was successfully treated with stenting for coronary artery disease. This intervention resolved symptoms and normalized the electrocardiogram findings.
Area of Science:
- Cardiology
- Diagnostic Electrocardiography
- Interventional Cardiology
Background:
- The case presents a 53-year-old male experiencing chest pain during an exercise treadmill test.
- Initial electrocardiogram (ECG) showed transient giant R-wave, right-axis deviation, intraventricular conduction delay, and inferolateral ST-segment elevation.
Observation:
- Coronary angiography revealed an 80% lesion in the mid-left circumflex artery.
- The patient underwent percutaneous coronary intervention and stenting of the left circumflex artery lesion.
- Follow-up revealed persistent but mild perfusion defects and disease progression in the right coronary artery.
Findings:
- The initial ECG pattern was characteristic of "giant R-wave syndrome."
- Severe coronary spasm superimposed on mild atherosclerosis in the right coronary artery was hypothesized as the cause.
- Ad hoc direct stenting of the right coronary artery lesion was performed.
Implications:
- Successful treatment of coronary artery disease, including stenting for complex lesions and spasm, can resolve "giant R-wave syndrome" and associated symptoms.
- This case highlights the importance of comprehensive coronary assessment and tailored interventional strategies.
- Long-term follow-up is crucial for monitoring disease progression and treatment efficacy in patients with complex coronary artery disease.