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左主干冠状动脉开口严重狭窄致 Welling 综合征 1 例报告

Wellen's syndrome caused by severe ostial stenosis of the left main coronary artery: a case report.

机构信息

Department of Cardiology, The People's Hospital of Kaizhou District, Chongqing, China.

Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

BMC Cardiovasc Disord. 2024 Nov 29;24(1):688. doi: 10.1186/s12872-024-04365-1.

Abstract

BACKGROUND

Wellen's syndrome may indicate severe stenosis or even occlusion of the proximal left anterior descending coronary artery. It may progress to acute myocardial infarction. Early recognition and an early invasive strategy are critical to avoiding impending myocardial injury. To our knowledge, only one case of Wellen's electrocardiogram patterns caused by left main coronary artery (LM) lesions has been reported.

CASE PRESENTATION

A 61-year-old man with a history of hypertension and smoking presented to the emergency department complaining of paroxysmal chest pain for the preceding 6 days. In the present case, the T-wave symmetric inversions in the V2 and V3 leads is associated with severe ostial stenosis of LM, which appears similar to Wellen's type B pattern.

CONCLUSIONS

Practitioners should familiarize themselves with such uncommon LM lesions patterns and perform emergent reperfusion therapy.

摘要

背景

Wellen 综合征可能表明左前降支近段严重狭窄甚至闭塞。它可能进展为急性心肌梗死。早期识别和早期介入策略对于避免即将发生的心肌损伤至关重要。据我们所知,仅报告过一例由左主干(LM)病变引起的 Wellen 心电图模式的病例。

病例介绍

一名 61 岁男性,有高血压和吸烟史,因前 6 天阵发性胸痛就诊于急诊科。在本例中,V2 和 V3 导联的 T 波对称倒置与 LM 开口严重狭窄有关,类似于 Wellen 型 B 模式。

结论

临床医生应熟悉这种不常见的 LM 病变模式,并进行紧急再灌注治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/335b/11606231/e9eaccaa0308/12872_2024_4365_Fig1_HTML.jpg

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