年轻患者Wellens综合征的T波动态演变1例

Dynamic T-wave evolution in a young patient with Wellens syndrome:a case report

Wellens综合征是心肌缺血的特殊表现形式,预示着冠状动脉(冠脉)前降支近端严重狭窄,其临床症状与心电图表现不平行,常引起漏诊和误诊。本文报道1例年轻的Wellens综合征患者,因心电图呈现“伪正常化”而被忽视,在院期间经皮冠脉介入(PCI)术后Wellens综合征的类型发生转变,胸导联T波从对称性深倒置转变为正负双向改变,由Ⅰ型转换为Ⅱ型。本文对该患者的T波动态演变特点进行讨论分析,并总结Wellens综合征容易发生漏诊和误诊的原因,以此提高对Wellens综合征的认识和警惕。

Wellens syndrome(WS)is a special manifestation of myocardial ischemia,which indicates severe stenosis of the proximal anterior descending coronary artery.Its clinical symptoms are not consistent with the electrocardiogram(ECG)manifestations,always leading to missed diagnoses and misdiagnoses.This paper reported a young patient with WS who was overlooked due to'pseudonormalization'displayed in ECG.During hospitalization,the type of WS changed from typeⅠto typeⅡafter PCI,with the T-wave in the chest leads changing from deep symmetrical inversion to positive and negative bi-direction.In this paper,the T-wave dynamic evolution characteristics of this patient were discussed and analyzed,and the reasons why WS is prone to misdiagnosis and missed diagnosis were summarized,highlighting the need for improving awareness and vigilance towards WS.