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导致非典型德维特心电图改变的不常见罪犯血管:病例报告。

Uncommon culprit artery leading to atypical de winter electrocardiographic changes: a case report.

机构信息

Department of Electrocardiology, The First Hospital of Jiaxing Affiliated Hospital of Jiaxing University, Jiaxing, 314001, China.

Department of Cardiology, The First Hospital of Jiaxing Affiliated Hospital of Jiaxing University, No.1882 Zhonghuan South Road, Jiaxing, Zhejiang, 314001, People's Republic of China.

出版信息

BMC Cardiovasc Disord. 2024 Sep 27;24(1):524. doi: 10.1186/s12872-024-04208-z.

DOI:10.1186/s12872-024-04208-z
PMID:39333928
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11430272/
Abstract

BACKGROUND

A subset of patients with acute coronary artery occlusion requiring emergency revascularization, does not present with the typical ECG features of ST-segment elevation myocardial infarction (STEMI).Timely identification of these atypical presentations is crucial.

CASE PRESENTATION

This report describes a 55-year-old male patient who was admitted to the emergency department with chest pain. The electrocardiogram (ECG) recorded atypical de Winter electrocardiographic changes and their evolution.

RESULTS

Coronary angiography confirmed the occlusion of the second diagonal branch (D2). The patient's condition improved after D2 balloon angioplasty.

CONCLUSION

De Winter electrocardiographic changes can also be observed in D2 occlusions and may present with milder manifestations. Timely recognition of these changes holds significant clinical value.

摘要

背景

需要紧急血运重建的急性冠状动脉闭塞患者中,存在一部分不表现出典型 ST 段抬高型心肌梗死(STEMI)的心电图特征。及时识别这些非典型表现至关重要。

病例介绍

本报告描述了一位 55 岁男性患者,因胸痛就诊于急诊科。心电图(ECG)记录到非典型的 de Winter 心电图改变及其演变。

结果

冠状动脉造影证实第二对角支(D2)闭塞。D2 球囊扩张后患者病情改善。

结论

de Winter 心电图改变也可在 D2 闭塞中观察到,且可能表现为较轻的征象。及时识别这些改变具有重要的临床价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34bf/11430272/0d3fd370da84/12872_2024_4208_Figf_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34bf/11430272/f8706ea7b99b/12872_2024_4208_Figa_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34bf/11430272/96fafb0e655b/12872_2024_4208_Figb_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34bf/11430272/f2eaea20d468/12872_2024_4208_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34bf/11430272/0d3fd370da84/12872_2024_4208_Figf_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34bf/11430272/f8706ea7b99b/12872_2024_4208_Figa_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34bf/11430272/96fafb0e655b/12872_2024_4208_Figb_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34bf/11430272/f2eaea20d468/12872_2024_4208_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34bf/11430272/0d3fd370da84/12872_2024_4208_Figf_HTML.jpg

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de Winter Electrocardiographic Pattern Caused by Diagonal Branch Lesion.对角支病变导致的de Winter心电图模式。
JACC Case Rep. 2020 Aug 19;2(10):1451-1453. doi: 10.1016/j.jaccas.2020.06.027. eCollection 2020 Aug.
3
The de Winter electrocardiographic pattern evolves to ST elevation in acute total left main occlusion: A case series.
急性完全性左主干闭塞时德温特心电图模式演变为 ST 段抬高:病例系列。
Ann Noninvasive Electrocardiol. 2022 Jan;27(1):e12855. doi: 10.1111/anec.12855. Epub 2021 May 27.
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A new electrocardiographic concept: V1-V2-V3 are not only horizontal, but also frontal plane leads.一个新的心电图概念:V1-V2-V3 导联不仅是水平的,而且也是额面导联。
J Electrocardiol. 2021 May-Jun;66:62-68. doi: 10.1016/j.jelectrocard.2021.02.014. Epub 2021 Mar 4.
5
The De Winter-like electrocardiogram pattern in inferior and lateral leads associated with left circumflex coronary artery occlusion.下壁和侧壁导联出现类似De Winter心电图模式,与左旋支冠状动脉闭塞相关。
ESC Heart Fail. 2020 Dec;7(6):4301-4304. doi: 10.1002/ehf2.12946. Epub 2020 Sep 14.
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