南方医科大学学报 ›› 2020, Vol. 40 ›› Issue (07): 919-921.doi: 10.12122/j.issn.1673-4254.2020.07.01

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de Winter综合征, 一种易被忽视却致命的疾病: 1例报告

肖园园,樊仲国,徐 宝,何胜虎   

  • 出版日期:2020-07-20 发布日期:2020-07-20
  • 基金资助:

de Winter syndrome, an easily ignored but life-threatening disease: a case report

  

  • Online:2020-07-20 Published:2020-07-20

摘要: de Winter综合征是与ST段抬高型心肌梗死等同的一种特殊疾病,其特征是没有明显的ST段抬高,表现为上斜型ST段压低,心前导联出现高而对称的T波,并通常与冠状动脉左前降支完全阻塞有关。本文中我们报告1例de Winter综合征病例,该63岁男性患者初始心电图未显示ST段抬高,但随后在冠状动脉造影中证实近端冠状动脉左前降支完全闭塞。该患者通过机械再灌注治疗和支架置入术后得到成功治疗。临床医生通常对此病认识不足,因此常导致较高的死亡率。迅速识别该综合征的这种ECG模式以确保及时通过经皮冠状动脉介入术进行有效的再灌注治疗对于挽救患者的生命至关重要。

关键词: de Winter综合征, ST段抬高型心肌梗死, 左前降支, 经皮冠状动脉介入术

Abstract: de Winter syndrome is a special equivalent of anterior ST-segment elevation myocardial infarction (STEMI) characterized by the absence of overt ST-elevation with upsloping ST-segment depression followed by tall symmetrical T-waves in the precordial leads, often associated with total occlusion of the proximal left anterior descending coronary artery. Herein we present a case of de Winter syndrome in a 63-year-old man, whose initial ECG showed no ST-segment elevation, but subsequent coronary angiography confirmed total occlusion of the proximal LAD coronary artery. The patient was successfully treated via mechanical reperfusion therapy and stenting through percutaneous coronary intervention (PCI). de Winter syndrome is associated with a high mortality often due to insufficient awareness of this condition by clinicians. Immediate reperfusion therapy by PCI is the life-saving treatment for the patients diagnosed with this syndrome, and prompt recognition of the ECG pattern is critical to ensure the timely administration of the therapy.

Key words: de Winter syndrome, ST-segment elevation myocardial infarction, left anterior descending, percutaneous coronary intervention