De Winter征一例报告

摘要： 部分急性冠脉综合征 （ACS） 患者心电图特点并不典型， 极易被漏诊。De Winter征是其中一种极为凶险的类型， 其应作为ST段抬高型心肌梗死的等危症进行管理， 应紧急行急诊冠状动脉造影检查， 尽快完成血运重建， 以防严重不良心血管事件的发生。本文报告1例De Winter征男性老年患者， 因心前区疼痛就诊， 体表心电图呈De Winter 征改变， 术前心肌损伤标志物未见异常， 冠状动脉造影示左前降支 （LAD） 自近段完全闭塞。因及时行冠状动脉造影及支架植入术， 预后良好。部分急性冠脉综合征 （ACS） 患者心电图特点并不典型， 极易被漏诊。De Winter征是其中一种极为凶险的类型， 其应作为ST段抬高型心肌梗死的等危症进行管理， 应紧急行急诊冠状动脉造影检查， 尽快完成血运重建， 以防严重不良心血管事件的发生。本文报告1例De Winter征男性老年患者， 因心前区疼痛就诊， 体表心电图呈De Winter 征改变， 术前心肌损伤标志物未见异常， 冠状动脉造影示左前降支 （LAD） 自近段完全闭塞。因及时行冠状动脉造影及支架植入术， 预后良好。

case report of one adult with de Winter syndrome and literature review

Abstract：The electrocardiogram (ECG) characteristics of some patients with acute coronary syndrome (ACS) are not typical and very susceptible to be misdiagnosed. De Winter syndrome is one of the most dangerous type of ACS, which should be considered as an equal risk of ST segment elevation myocardial infarction. Emergency coronary angiography should be urgently performed to complete revascularization as soon as possible to prevent serious adverse cardiovascular events. We report a case of a 77-year-old male patient with De Winter syndrome, whose initial complaint was acute chest pain. The result of ECG showed changes of De Winter sign. It has been associated with proximal occlusion of the left anterior descending (LAD) coronary artery, even though there was no abnormal sign of myocardial injury markers. Timely reperfusion therapy by means of primary percutaneous coronary intervention (PCI) was the preferred treatment for patients with De Winter syndrome. The subsequent clinical course was uneventful.