Thrombolytic therapy in a patient with chest pain with de Winter ECG pattern occurred after ST-segment elevation: A
Weiwei Xu1, Liaohang Xu1, Jiren Peng1
1Department of Cardiology, Affiliated Dongyang People's Hospital of Wenzhou Medical University, Dongyang, Zhejiang Province 322100, PR China.
Insights
The de Winter electrocardiogram (ECG) pattern, indicative of proximal left anterior descending artery occlusion, can be successfully treated with thrombolytic therapy when urgent cardiac catheterization is unavailable. This approach offers a vital alternative for acute myocardial infarction management.
Area of Science:
- Cardiology
- Emergency Medicine
Background:
- The de Winter electrocardiogram (ECG) pattern is associated with proximal left anterior descending artery (LAD) occlusion.
- It is often managed as an ST-segment elevation myocardial infarction (STEMI) equivalent, necessitating urgent angiography and reperfusion.
- However, timely access to cardiac catheterization facilities is not universally available.
Abstract:
The de Winter electrocardiogram (ECG) pattern may signify proximal left anterior descending artery (LAD) occlusion and was suggested to be managed as ST-segment elevation myocardial infarction (STEMI) equivalent for urgent angiography and reperfusion therapy. However, cardiac catheter laboratory is not readily or timely available in every hospital. When timely percutaneous coronary intervention (PCI) is not available, thrombolytic therapy can be considered in patients with ongoing ischemia symptoms. Here, we present a case of a successful thrombolytic therapy with de Winter ECG pattern occurred after ST-segment elevation in a scenario which the catheter laboratory was unavailable.
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