Wang Fei, Zhang Xuesong, Pang Huihui, Wang Yuehai
Department of Cardiology, Shandong Corps Hospital of Chinese People's Armed Police Forces, Jinan, Shandong, China.
Cardiology Department and Experimental Animal Center, Liaocheng People's Hospital of Shandong University and Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng, Shandong, China.
Front Cardiovasc Med. 2025 Jan 9;11:1415306. doi: 10.3389/fcvm.2024.1415306. eCollection 2024.
Both de Winter syndrome and Wellens syndrome mainly indicate severe stenosis in the proximal segment of the anterior descending coronary artery. However, as research deepens, the accuracy and specificity of diagnosing proximal left anterior descending coronary artery (LAD) culprit lesions separately by de Winter syndrome or Wellens syndrome are challenged. The patient in this case developed both syndromes in a short period of time, and imaging showed significant stenosis of the proximal LAD, indicating a culprit lesion. The successive appearance of these two special electrocardiogram changes may increase the accuracy and specificity of diagnosing LAD as a culprit lesion, and the short-term occurrence of these two special electrocardiogram changes also suggests that the culprit lesion may be incomplete occlusion. In addition, de Winter syndrome is prone to missed diagnosis, while Wellens syndrome is prone to misdiagnosis or underestimation of its risk.
de Winter综合征和Wellens综合征均主要提示前降支冠状动脉近端严重狭窄。然而，随着研究的深入，单独通过de Winter综合征或Wellens综合征诊断左前降支冠状动脉（LAD）近端罪犯病变的准确性和特异性受到挑战。该病例患者在短时间内出现了这两种综合征，影像学检查显示LAD近端明显狭窄，提示为罪犯病变。这两种特殊心电图改变的相继出现可能会提高将LAD诊断为罪犯病变的准确性和特异性，而且这两种特殊心电图改变的短期出现也提示罪犯病变可能为不完全闭塞。此外，de Winter综合征容易漏诊，而Wellens综合征容易误诊或低估其风险。
