Xu Weiwei, Zou He, Huang Shiwei
Department of Cardiology Medicine, Affiliated Dongyang People's Hospital of Wenzhou Medical University, Dongyang, Zhejiang Province 322100, PR China.
Department of Cardiology, Wenzhou People's Hospital, Wenzhou, Zhejiang Province 325000, PR China.
J Electrocardiol. 2019 May-Jun;54:40-42. doi: 10.1016/j.jelectrocard.2019.03.006. Epub 2019 Mar 7.
A 54-year-old man presented to the emergency department with chest pain and electrocardiogram (ECG) changes of acute ST-segment elevation myocardial infarction (STEMI) and junctional ST-depression with tall symmetrical T-waves (de Winter T-wave) in the lateral and inferior leads. Emergent coronary angiography revealed a culprit lesion in the gigantic obtuse marginal artery (OM). This case demonstrates the de Winter T-wave can occur in a patient with an acute occlusion of OM. Emergency physicians, ambulance staff, cardiologists and all involved in STEMI networks should familiarize themselves with this unusual ECG pattern and consider transferring patients for urgent angiography and reperfusion therapy.
一名54岁男性因胸痛就诊于急诊科，心电图（ECG）显示急性ST段抬高型心肌梗死（STEMI），侧壁和下壁导联出现交界性ST段压低伴高耸对称T波（de Winter T波）。急诊冠状动脉造影显示巨大钝缘支动脉（OM）存在罪犯病变。该病例表明，OM急性闭塞患者可出现de Winter T波。急诊医生、救护人员、心脏病专家以及所有参与STEMI网络的人员都应熟悉这种不寻常的心电图模式，并考虑将患者转运至上级医院进行紧急血管造影和再灌注治疗。
