Clinical features of patients with acute myocardial infarction presenting de Winter pattern on electrocardiogram
10.3760/cma.j.cn114798-20210220-00168
- VernacularTitle:呈de Winter型心电图改变的急性心肌梗死患者临床特征分析
- Author:
Yumei WEN
1
;
Jincheng GUO
;
Ping LI
;
Shenghui ZHOU
;
Rui YAN
;
Jiahui SONG
Author Information
1. 首都医科大学附属北京潞河医院医疗保健病区 101100
- Keywords:
Electrocardiogram;
Myocardial infarction;
de Winter;
Left anterior descending branch
- From:
Chinese Journal of General Practitioners
2021;20(8):868-872
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analysis the clinical features of patients with acute myocardial infarction (AMI) presenting de Winter pattern on electrocardiogram.Methods:A total of 1 287 patients with AMI admitted to Beijing Luhe Hospital between June 2017 and January 2019 were enrolled in the study. Electrocardiogram and clinical features of 13 patients with AMI presenting de Winter pattern on electrocardiogram were analyzed and compared with anterior wall ST-segment elevation myocardial infarction(STEMI, n=206). Results:Among the 13 patients, 12 were males, aged (52.23±12.55) years old. Compared to patients with anterior wall STEMI, the age in the de Winter group was younger [(52.23±12.55)years vs. (59.79±12.46)years; t=-2.12, P=0.03], and the time from onset to appearing a typical ECG was shorter [109.0 (71.5, 152.0)min vs. 200.5 (120.0, 397.5)min; Z=-3.38, P<0.01]. Three cases showed a shifting between de Winter pattern and typical STEMI ECG: the de Winter ECG pattern progressed to STEMI in 2 cases, 1 case changed from STEMI to de Winter,then converted to STEMI again. The emergency angiography was performed in all 13 patients, angiography showed that proximal left anterior descending branch (LAD) was involved in 11 cases, mid LAD was involved in 1 case, and diffuse spasm occurred in all vessels in 1 case. The de Winter ECG pattern vanished in all patients after primary percutaneous coronary intervention or emergency angiography. Conclusions:The de Winter ECG pattern suggests an acute proximal or mid LAD artery occlusion, and the de Winter ECG pattern can be alternated with STEMI. The de Winter pattern should be recognized and revascularization should be given early.
