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儿童de Winter综合征一例
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Abstract:
de winter综合征特征心电图表现为上斜性ST段压低伴T波对称高尖，很快进展为ST段抬高型心肌梗死，及早识别该心电图演变，早期行冠脉血运重建治疗，挽救患者生命。本文报道1例10岁患儿心电图早期出现de winter表现，结合心肌酶及肌钙蛋白的动态改变，完善冠脉造影检查，证实为前降支(Left anterior descending, LAD)近段急性闭塞病变，给予行急诊介入治疗。
The characteristic ECG of de Winter syndrome is up-slope ST-segment depression with symmetric high apex of T wave, which quickly progresses to ST-segment elevation myocardial infarction. Such ECG pattern should be identified early and emergency reperfusion therapy saves the patient's life. We report a 10-year-old child with early ECG manifestations of de winter. Combined with the dynamic changes of myocardial enzymes and troponin, the coronary angiography examination was perfected with emergency interventional therapy.
| [1] | de Winter, R.J., Verouden, N.J., Wellens, H.J., et al. (2008) A New ECG Sign of Proximal LAD Occlusion. The New England Journal of Medicine, 359, 2071-2073. https://doi.org/10.1056/NEJMc0804737 |
| [2] | John, T.J., Pecoraro, A., Weich, H., et al. (2020) The de Winter’s Pattern Revisited: A Case Series. European Heart Journal—Case Reports, 4, 1-5. https://doi.org/10.1093/ehjcr/ytaa402 |
| [3] | Niimi, N., Ooka, R., Shiraishi, Y., et al. (2020) de Winter ST-T Complex. QJM, 113, 582-583.
https://doi.org/10.1093/qjmed/hcz295 |
| [4] | 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南[J]. 中华心血管病杂志, 2019, 47(10): 766-783. |
| [5] | de Graeff, N., Groot, N., Ozen, S., et al. (2019) European Consensus-Based Recommendations for the Diagnosis and Treatment of Kawasaki Disease—The SHARE Initiative. Rheumatology, 58, 672-682.
https://doi.org/10.1093/rheumatology/key344 |
| [6] | Tsimikas, S., Fazio, S., Ferdinand, K.C., et al. (2018) NHLBI Working Group Recommendations to Reduce Lipoprotein(a)-Mediated Risk of Cardiovascular Disease and Aortic Ste-nosis. Journal of the American College of Cardiology, 71, 177-192. https://doi.org/10.1016/j.jacc.2017.11.014 |
| [7] | 中华医学会儿科学分会心血管学组, 中华儿科杂志编辑委员会. 川崎病冠状动脉病变的临床处理建议(2020年修订版) [J]. 中华儿科杂志, 2020, 58(9): 718-724. |
| [8] | 《药物涂层球囊临床应用中国专家共识》专家组. 药物涂层球囊临床应用中国专家共识[J]. 中国介入心脏病学杂志, 2016, 24(2): 61-67. |
| [9] | 中华医学会心血管病学分会. 冠状动脉生物可吸收支架临床应用中国专家共识[J]. 中华心血管病杂志, 2020, 48(5): 350-358. |
| [10] | Thygesen, K., Alppert, J.S., Jaffe, A.S., et al. (2018) Fourth Universal Definition of Myocardial Infarction. Journal of the American College of Cardiology, 72, 2231-2264. https://doi.org/10.1016/j.jacc.2018.08.1038 |
