Goktas Mustafa Ugur, Sogut Ozgur, Yigit Mehmet, Kaplan Onur
Department of Emergency Medicine, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Cardiol Res. 2017 Aug;8(4):165-168. doi: 10.14740/cr576w. Epub 2017 Aug 23.
Patients with de Winter syndrome, also termed anterior ST-segment elevation myocardial infarction (STEMI)-equivalent, represent 2% of all patients with acute anterior myocardial infarctions admitted to emergency departments (EDs). STEMI-equivalents do not present with classical electrocardiogram (ECG) changes but exhibit a critical stenosis of the left anterior descending (LAD) coronary artery. This is under-recognized by clinicians and is therefore associated with high morbidity and mortality. Here, we report a rare case of a novel, typical, STEMI-equivalent ECG pattern without obvious ST-segment elevation in a 34-year-old female who presented to our ED with substantial chest pain and a large, acute, transmural anterior myocardial infarction caused by acute occlusion of the LAD coronary artery. However, she presented as a non-STEMI case. A definite diagnosis of de Winter syndrome was made on the basis of clinical and ECG findings.
患有德温特综合征（也称为前壁ST段抬高型心肌梗死等效症）的患者占急诊部门收治的所有急性前壁心肌梗死患者的2%。ST段抬高型心肌梗死等效症患者不表现出典型的心电图（ECG）变化，但左前降支（LAD）冠状动脉存在严重狭窄。临床医生对此认识不足，因此其发病率和死亡率较高。在此，我们报告一例罕见病例，一名34岁女性因严重胸痛就诊于我们的急诊科，心电图表现为一种新型、典型的ST段抬高型心肌梗死等效症模式，无明显ST段抬高，由LAD冠状动脉急性闭塞导致大面积急性透壁前壁心肌梗死。然而，她最初表现为非ST段抬高型心肌梗死病例。根据临床和心电图检查结果确诊为德温特综合征。
