冬季心电图形演变为穿皮术后冠状动脉干预治疗中的Wellens心电图形:一个案例报告
1Department of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin 300211, China.
European heart journal. Case reports
|July 21, 2025
概括
德温特心电图 (ECG) 模式可以在通过皮肤进行冠状动脉干预 (PCI) 后演变为威伦斯心电图模式,用于左前下降动脉 (LAD) 阻塞. 这一案例突出了急性冠状动脉综合征 (ACS) 的PCI后关键ECG监测.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 诊断性心电图谱 诊断性心电图谱
背景情况:
- 德·温特和威伦斯心电图 (ECG) 模式是近道左前下垂 (LAD) 冠状动脉封闭的关键指标,通常需要紧急干预.
- 在皮肤穿透冠状动脉干预 (PCI) 后,冬季心电图模式向惠伦斯心电图模式的过渡存在有限的数据.
研究的目的:
- 报告一个患有急性冠状动脉综合征 (ACS) 的病例,在成功进行PCI后,de Winter心电图模式转变为Wellens模式.
- 强调串行心电图监测在识别不断演变的高风险心脏模式方面的重要性.
主要方法:
- 一名73岁的男性出现了急性冠状动脉综合征和冬季心电图模式.
- 紧急冠状动脉血管学揭示了显著的近端LAD狭窄,用药物释放的支架放置治疗.
- 在PCI后进行了连续的ECG监测.
主要成果:
- 成功的PCI导致恢复LAD血流 (TIMI 3).
- 在PCI后24小时内,患者的心电图演变为B型Wellens模式,胸痛消失.
- 病人在医院第七天就出院了.
结论:
- 冬季心电图模式可以表示急性LAD阻塞,而其演变为PCI后的惠伦斯模式可能表明再输液.
- 持续的ECG监测对于识别动态的ECG变化和指导ACS中的管理至关重要.
- 在心前线索中的韦伦斯模式并不总是证实LAD阻塞.
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