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De Winter electrocardiogram pattern due to type A aortic dissection: a case report
BACKGROUND: De Winter electrocardiograph (ECG) pattern is an atypical presentation of acute myocardial infarction (AMI) due to severe stenosis of the left anterior descending (LAD). Complications of acute aortic dissection (AD) in the setting of acute myocardial infarction (AMI) with de Winter sign...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8981714/ https://www.ncbi.nlm.nih.gov/pubmed/35382768 http://dx.doi.org/10.1186/s12872-022-02596-8 |
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author | Zhang, Qing Yang, Dong-dong Xu, Yi-fei Qiu, Yuan-gang Zhang, Zhuo-yi |
author_facet | Zhang, Qing Yang, Dong-dong Xu, Yi-fei Qiu, Yuan-gang Zhang, Zhuo-yi |
author_sort | Zhang, Qing |
collection | PubMed |
description | BACKGROUND: De Winter electrocardiograph (ECG) pattern is an atypical presentation of acute myocardial infarction (AMI) due to severe stenosis of the left anterior descending (LAD). Complications of acute aortic dissection (AD) in the setting of acute myocardial infarction (AMI) with de Winter sign are relatively rare and physicians may easily miss the diagnosis of AD. We report a case of patient with acute chest pain and de Winter ECG pattern due to AD involving the left main coronary artery (LM), LAD and left circumflex artery (LCX). CASE PRESENTATION: A 57-year-old male patient was initially diagnosed with AMI and then the diagnosis of acute AD was supported by transthoracic echocardiograph (TTE). After two stents were implanted respectively into the proximal LM-LAD and LM-LCX, he recovered from cardiogenic shock. Two months later, the patient underwent the surgery of ascending aorta replacement. After the surgery, there was no obvious chest discomfort during follow-up. CONCLUSIONS: When an ECG shows a “de Winter pattern”, we should also consider the possibility of AD which result in LAD occlusion. TTE is a useful tool in screening for AD. Further research is needed to prove that percutaneous coronary intervention (PCI) may be a useful treatment strategy in the case of AD leading to severe LAD occlusion and unstable hemodynamics when there’s no condition to perform aortic replacement surgery immediately. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-022-02596-8. |
format | Online Article Text |
id | pubmed-8981714 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-89817142022-04-06 De Winter electrocardiogram pattern due to type A aortic dissection: a case report Zhang, Qing Yang, Dong-dong Xu, Yi-fei Qiu, Yuan-gang Zhang, Zhuo-yi BMC Cardiovasc Disord Case Report BACKGROUND: De Winter electrocardiograph (ECG) pattern is an atypical presentation of acute myocardial infarction (AMI) due to severe stenosis of the left anterior descending (LAD). Complications of acute aortic dissection (AD) in the setting of acute myocardial infarction (AMI) with de Winter sign are relatively rare and physicians may easily miss the diagnosis of AD. We report a case of patient with acute chest pain and de Winter ECG pattern due to AD involving the left main coronary artery (LM), LAD and left circumflex artery (LCX). CASE PRESENTATION: A 57-year-old male patient was initially diagnosed with AMI and then the diagnosis of acute AD was supported by transthoracic echocardiograph (TTE). After two stents were implanted respectively into the proximal LM-LAD and LM-LCX, he recovered from cardiogenic shock. Two months later, the patient underwent the surgery of ascending aorta replacement. After the surgery, there was no obvious chest discomfort during follow-up. CONCLUSIONS: When an ECG shows a “de Winter pattern”, we should also consider the possibility of AD which result in LAD occlusion. TTE is a useful tool in screening for AD. Further research is needed to prove that percutaneous coronary intervention (PCI) may be a useful treatment strategy in the case of AD leading to severe LAD occlusion and unstable hemodynamics when there’s no condition to perform aortic replacement surgery immediately. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-022-02596-8. BioMed Central 2022-04-05 /pmc/articles/PMC8981714/ /pubmed/35382768 http://dx.doi.org/10.1186/s12872-022-02596-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Zhang, Qing Yang, Dong-dong Xu, Yi-fei Qiu, Yuan-gang Zhang, Zhuo-yi De Winter electrocardiogram pattern due to type A aortic dissection: a case report |
title | De Winter electrocardiogram pattern due to type A aortic dissection: a case report |
title_full | De Winter electrocardiogram pattern due to type A aortic dissection: a case report |
title_fullStr | De Winter electrocardiogram pattern due to type A aortic dissection: a case report |
title_full_unstemmed | De Winter electrocardiogram pattern due to type A aortic dissection: a case report |
title_short | De Winter electrocardiogram pattern due to type A aortic dissection: a case report |
title_sort | de winter electrocardiogram pattern due to type a aortic dissection: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8981714/ https://www.ncbi.nlm.nih.gov/pubmed/35382768 http://dx.doi.org/10.1186/s12872-022-02596-8 |
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