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Case Reports
. 2020 Jul 30;40(7):919-921.
doi: 10.12122/j.issn.1673-4254.2020.07.01.

[de Winter syndrome, an easily ignored but life-threatening disease: a case report]

[Article in Chinese]
Xiao Yuanyuan  1 , Fan Zhongguo  1 , X U Bao  2 , H E Shenghu  1
Affiliations
Case Reports

[de Winter syndrome, an easily ignored but life-threatening disease: a case report]

[Article in Chinese]
Xiao Yuanyuan et al. Nan Fang Yi Ke Da Xue Xue Bao. .

Abstract

de Winter syndrome is a special equivalent of anterior ST-segment elevation myocardial infarction (STEMI) characterized by the absence of overt ST-elevation with upsloping ST-segment depression followed by tall symmetrical T-waves in the precordial leads, often associated with total occlusion of the proximal left anterior descending coronary artery. Herein we present a case of de Winter syndrome in a 63-year-old man, whose initial ECG showed no ST-segment elevation, but subsequent coronary angiography confirmed total occlusion of the proximal LAD coronary artery. The patient was successfully treated via mechanical reperfusion therapy and stenting through percutaneous coronary intervention (PCI). de Winter syndrome is associated with a high mortality often due to insufficient awareness of this condition by clinicians. Immediate reperfusion therapy by PCI is the life-saving treatment for the patients diagnosed with this syndrome, and prompt recognition of the ECG pattern is critical to ensure the timely administration of the therapy.

Keywords: ST-segment elevation myocardial infarction; de Winter syndrome; left anterior descending; percutaneous coronary intervention.

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Figures

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ECG and coronary angiography findings of the patient before and after PCI. A: Immediate 12- lead ECG of the patient after admission to the emergency department; B: Characteristics of initial coronary angiography; C: Repeated ECG after PCI; D: Repeated coronary angiography after stenting.
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Changes in serum levels of cTnI, CK-MB, myoglobin (A) and NT-pro BNP (B) of the patient after admission.
See this image and copyright information in PMC

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