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作为ST段抬高型心肌梗死等效表现的“de Winter”心电图模式：一例病例报告。

The 'de Winter' electrocardiogram pattern as a ST-elevation myocardial infarction equivalent: a case report.

作者信息

Grandjean Thierry, Degrauwe Sophie, Tessitore Elena, Iglesias Juan F

机构信息

Department of Cardiology, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.

出版信息

Eur Heart J Case Rep. 2019 Dec;3(4):1-5. doi: 10.1093/ehjcr/ytz210. Epub 2019 Nov 27.

DOI:10.1093/ehjcr/ytz210
PMID:31911997
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6939815/
Abstract

BACKGROUND

A 'STEMI equivalent' electrocardiogram (ECG) pattern reflects an acute thrombotic occlusion of a large epicardial coronary artery without ST-segment elevation. These ECG patterns are less known by caregivers.

CASE SUMMARY

We describe the case of a 56-year-old patient suffering from acute chest pain, presenting in our emergency department with a 'de Winter' ECG pattern: an upsloping ST-segment depression with tall symmetrical T waves associated with left anterior descending artery occlusion.

DISCUSSION

The 'de Winter' ECG pattern, as other 'STEMI equivalent', must be recognized promptly and treated as soon as possible with emergent reperfusion by percutaneous coronary intervention.

摘要

背景

“ST段抬高型心肌梗死等效”心电图模式反映了无ST段抬高的大型心外膜冠状动脉急性血栓性闭塞。护理人员对这些心电图模式了解较少。

病例摘要

我们描述了一名56岁急性胸痛患者的病例，该患者在我们急诊科表现出“de Winter”心电图模式：ST段上斜型压低伴高尖对称T波，与左前降支动脉闭塞有关。

讨论

“de Winter”心电图模式与其他“ST段抬高型心肌梗死等效”模式一样，必须迅速识别，并尽快通过经皮冠状动脉介入进行紧急再灌注治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f19/6939815/4d30c5c58bd0/ytz210f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f19/6939815/988bcbcb0f1f/ytz210f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f19/6939815/ac35dfd3233a/ytz210f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f19/6939815/00a210334c69/ytz210f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f19/6939815/4d30c5c58bd0/ytz210f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f19/6939815/988bcbcb0f1f/ytz210f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f19/6939815/ac35dfd3233a/ytz210f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f19/6939815/00a210334c69/ytz210f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f19/6939815/4d30c5c58bd0/ytz210f4.jpg

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本文引用的文献

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J Electrocardiol. 2019 Jan-Feb;52:1-5. doi: 10.1016/j.jelectrocard.2018.10.092. Epub 2018 Oct 18.
2
The de winter electrocardiogram pattern is a transient electrocardiographic phenomenon that presents at the early stage of ST-segment elevation myocardial infarction.de Winter心电图模式是一种短暂的心电图现象，出现在ST段抬高型心肌梗死的早期。
Clin Cardiol. 2018 Sep;41(9):1177-1184. doi: 10.1002/clc.23002. Epub 2018 Sep 22.
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德温特心电图模式：ST 段压低的分布和形态。
Ann Noninvasive Electrocardiol. 2020 Sep;25(5):e12783. doi: 10.1111/anec.12783. Epub 2020 Jun 25.
The de Winter ECG Pattern in the Absence of Acute Coronary Artery Occlusion.
无急性冠状动脉闭塞时的德温特心电图模式。
Can J Cardiol. 2018 Feb;34(2):209.e1-209.e3. doi: 10.1016/j.cjca.2017.11.014. Epub 2017 Nov 29.
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2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC).2017年欧洲心脏病学会（ESC）ST段抬高型急性心肌梗死患者管理指南：欧洲心脏病学会（ESC）ST段抬高型急性心肌梗死患者管理工作组
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