de Winter心电图表现为急性心肌梗死1例

A rare ECG pattern accounts for acute myocardial infarction:a case report

1 病例资料患者,男,36岁,因'反复胸痛1周,再发并加重1 h'入院。患者1周前因'感冒'出现间断胸痛,伴咳嗽和咯黄痰,自行服用头孢拉定以后咳嗽和咯痰缓解,胸痛仍旧存在。约1 h前无明显诱因胸痛再发,较前加重并向左肩放射,胸痛呈压榨性,伴胸部紧缩感,持续半小时左右未能缓解,即来我院急诊科就诊。患者无冠心病家族史,无吸烟史和糖尿病病史。

We report a young male patient whose electrocardiogram was characterized by slight elevation in STaVR-segment,upsloping ST-segment depression at the J point in leads V1 to V6,continued into tall,positive,and symmetrical T waves,which was a typically de Winter pattern.An emergent coronary angiography was performed and the procedure revealed a totally occlusion of the proximal left anterior descending coronary artery(LAD),no collateral blood supply was detected.Percutaneous coronary intervention was successfully executed and a drug eluting stent was placed after balloon dilatation in occlusive segment,the distal LAD blood flow restored to TIMI-3 grade flow thereafter.