Xenogiannis Iosif, Kolokathis Fotios, Alexopoulos Dimitrios, Rallidis Loukianos S
Second Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Greece.
Second Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Greece.
J Electrocardiol. 2023 Jan-Feb;76:26-31. doi: 10.1016/j.jelectrocard.2022.11.002. Epub 2022 Nov 9.
Left main coronary artery (LMCA) total occlusion typically presents as anterolateral ST-segment myocardial infarction with or without right bundle branch block with left anterior fascicular block, and ST-segment elevation in aVR. On the contrary to the previously described electrocardiographic pattern we describe a distinct electrocardiographic presentation in a patient with total LMCA occlusion characterized by the presence of complete LBBB co-existing with upsloping ST-segment depression in precordial leads leading to symmetrical, tall, positive T waves, the so called de Winter's sign.
左主干冠状动脉（LMCA）完全闭塞通常表现为前外侧ST段心肌梗死，伴或不伴有右束支传导阻滞合并左前分支阻滞，以及aVR导联ST段抬高。与先前描述的心电图模式相反，我们描述了一例LMCA完全闭塞患者独特的心电图表现，其特征为完全性左束支传导阻滞（LBBB）与胸前导联ST段上斜型压低并存，导致T波对称、高耸、直立，即所谓的de Winter征。
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