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Patrón electrocardiográfico "De Winter" en el bloqueo de la rama izquierda y oclusión coronaria aguda: un informe de

Hugo Leonardi Baldisserotto1, Andressa Daga2, Guilherme Heiden Telo2

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El patrón del ECG de De Winter puede indicar una oclusión coronaria aguda, incluso con un bloqueo de la rama izquierda. El reconocimiento y el tratamiento inmediatos de este equivalente STEMI son vitales para los resultados de los pacientes.

Palabras clave:
Oclusión coronaria agudaInforme sobre el casoEl patrón de De WinterBloqueo de la rama del haz izquierdo

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Área de la Ciencia:

  • Cardiología
  • La electrocardiografía

Sus antecedentes:

  • La elevación del segmento ST en el electrocardiograma (ECG) generalmente significa oclusión coronaria aguda.
  • Los patrones electrocardiográficos como los de Wellens y De Winter se reconocen como equivalentes al infarto de miocardio por elevación del segmento ST (STEMI).
  • El diagnóstico de STEMI requiere un rápido reconocimiento de los hallazgos específicos del ECG para una terapia de reperfusión oportuna.

Objetivo del estudio:

  • Para resaltar la importancia del patrón de ECG de De Winter como un equivalente de STEMI.
  • Hacer hincapié en la importancia de reconocer patrones específicos de ECG para el diagnóstico rápido y la terapia de reperfusión.
  • Para discutir los desafíos de diagnóstico planteados por condiciones coexistentes como el bloqueo de la rama del haz izquierdo.

Principales métodos:

  • Presentación del caso de una mujer de 79 años con dolor en el pecho y un patrón de ECG de De Winter.
  • El tratamiento inicial y el posterior cateterismo cardíaco.
  • Intervención con angioplastia para la oclusión de la arteria descendente anterior izquierda.

Principales resultados:

  • El paciente presentaba dolor en el pecho, un bloqueo de la rama izquierda y un patrón de De Winter en el ECG.
  • El cateterismo cardíaco reveló una oclusión trombótica de la arteria descendente anterior izquierda.
  • La angioplastia exitosa resultó en éxito angiográfico y mejoría clínica.

Conclusiones:

  • El patrón de De Winter es un indicador crítico de oclusión coronaria aguda y STEMI.
  • El reconocimiento y la gestión inmediatos de los equivalentes de STEMI son esenciales para reducir la morbilidad y la mortalidad.
  • La presencia de bloqueo de la rama izquierda puede complicar la interpretación del ECG, pero no impide el diagnóstico de los equivalentes de STEMI.