Related Experiment Video

Updated: May 31, 2026

Real-Time Electrocardiogram Monitoring During Treadmill Training in Mice
04:45

Real-Time Electrocardiogram Monitoring During Treadmill Training in Mice

Published on: May 5, 2022

"Giant R wave" electrocardiogram pattern during exercise treadmill test: A case report

Ana Testa-Fernández1, Ramón Rios-Vazquez, Juan Sieira-Rodríguez-Moret

  • 1Department of Cardiology, Hospital Lucus Augusti, San Cibrao s/n, Lugo E-27003, Spain. ana.testa.fernandez@gmail.com.

Journal of Medical Case Reports
|July 13, 2011
PubMed

Insights

A rare "giant R wave" during an exercise treadmill test indicated severe ischemia. Prompt nitroglycerin administration resolved the issue, highlighting its importance in preventing critical cardiac events.

Area of Science:

  • Cardiology
  • Diagnostic Imaging

Background:

  • The exercise treadmill test is a standard tool for evaluating coronary artery disease.
  • ST-segment depression is the typical ischemic response observed.

Purpose of the Study:

  • To report a rare case of a "giant R wave" pattern as an unusual ischemic response during an exercise treadmill test.
  • To discuss the clinical implications and management of this dramatic electrocardiogram finding.

Main Methods:

  • Case report of a 51-year-old man presenting with an unusual ischemic response on exercise treadmill test.
  • Coronary catheterization to identify the underlying coronary artery pathology.
  • Treatment with sublingual nitroglycerin and subsequent percutaneous coronary intervention.

Main Results:

  • The patient exhibited a "giant R wave" pattern, indicative of hyperacute ischemia.
  • Coronary angiography revealed severe stenosis in a proximal dominant circumflex artery, likely exacerbated by coronary spasm.
  • The ischemic response resolved rapidly following sublingual nitroglycerin administration.

Conclusions:

  • The "giant R wave" pattern represents a rare and dramatic manifestation of acute myocardial ischemia during exercise testing.
  • Early recognition and rapid treatment with nitroglycerin are crucial for preventing potentially life-threatening cardiac events in such cases.
Abstract

More Related Videos

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System10:17

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

Related Concept Videos

Electrocardiogram01:29

Electrocardiogram

An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and the T...
Exercise Stress Test01:26

Exercise Stress Test

Introduction
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
ECG Interpretation of Rhythms01:24

ECG Interpretation of Rhythms

An electrocardiogram (ECG)graphically represents the heart's electrical activity on ECG paper or a monitor.
Components of the Electrocardiogram
The primary components of a normal ECG waveform in Normal sinus rhythm(NSR) include the P wave, PR interval, QRS complex, ST segment, T wave, and occasionally a U wave.
ECG waveforms are divided by vertical and horizontal lines at standard intervals.
The horizontal axis measures time and rate, and the vertical axis measures amplitude or voltage. When...
Electrocardiogram Fundamentals01:28

Electrocardiogram Fundamentals

Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin to...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
Dysrhythmias V: Evaluating Dysrhythmias01:30

Dysrhythmias V: Evaluating Dysrhythmias

Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...