Case Report: Dynamic J-point elevation as a novel precursor to torsade de pointes: electrocardiographic markers for proactive management

This case report presents a 41-year-old male who experienced out-of-hospital cardiac arrest (OHCA) and was successfully resuscitated through prehospital emergency medical services and in-hospital advanced cardiovascular life support. Continuous electrocardiographic (ECG) monitoring revealed a unique pattern of J-point and ST-segment elevation in lead II, which preceded the development of torsade de pointes (TdP). The complete ECG evolution, from initial J-point elevation to the onset of polymorphic ventricular tachycardia, was meticulously documented. This rare case provides valuable insights into the electrocardiographic precursors of malignant ventricular arrhythmias and highlights the importance of continuous ECG monitoring in identifying high-risk patients.