Rotondaro Julio C, Delgado Gaete Mauricio, Fernandez Villar Gonzalo, Domenech Pilar, Bezazian Constanza, Pizarro Rodolfo
Servicio de Clínica Médica,Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina. E-mail:
Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires, Argentina.
Medicina (B Aires). 2022;82(5):787-790.
We present the case of a 40-year-old male without cardiovascular risk factors, who was admitted to our hospital due to chest pain. The electrocardiogram showed a typical pattern, already described, known as Wellens syndrome type 1 or A, characterized by ST segment elevation <1 mm and biphasic T wave in lead V3. Was diagnosed of acute myocardial infarction without ST elevation, TIMI 3 and GRACE score 66 points. This electrocardiographic pattern is of high risk, beyond the stratifying scores, since it correlates with severe injury to the anterior descending artery at the proximal level and requires percutaneous intervention without delay. The coronary angiography revealed 3 severe lesions: the proximal and middle thirds of the left anterior descending artery and the first diagonal. We highlight the validity of this electrocardiographic pattern, described more than 40 years ago, to identify and stratify patients with acute coronary syndrome.
我们报告一例40岁无心血管危险因素的男性患者,因胸痛入院。心电图显示一种已被描述过的典型模式,即1型或A型Wellens综合征,其特征为V3导联ST段抬高<1mm及T波双向。诊断为非ST段抬高型急性心肌梗死,TIMI 3级,GRACE评分66分。这种心电图模式具有高风险,超出了分层评分范围,因为它与前降支近端的严重损伤相关,需要立即进行经皮介入治疗。冠状动脉造影显示3处严重病变:左前降支近端和中段以及第一对角支。我们强调这种40多年前描述的心电图模式在识别和分层急性冠状动脉综合征患者方面的有效性。