年轻患者Wellens综合征的T波动态演变1例

谢雪萍; 郑周玲

doi:10.13201/j.issn.1001-1439.2023.09.015

年轻患者Wellens综合征的T波动态演变1例

谢雪萍¹,
郑周玲^1, ,

- 福州市第二医院心电诊断科(福州，350007)

详细信息

通讯作者: 郑周玲，E-mail：zzlinga@163.com

中图分类号: R542.2

收稿日期: 2023-03-16

刊出日期: 2023-09-13

Dynamic T-wave evolution in a young patient with Wellens syndrome: a case report

XIE Xueping¹,
ZHENG Zhouling^1, ,

- Department of ECG Diagnosis, The Second Hospital of Fuzhou, Fuzhou, 350007, China

More Information

Corresponding author: ZHENG Zhouling, E-mail: zzlinga@163.com

Received Date: 16 March 2023

Publish Date: 13 September 2023

摘要

摘要: Wellens综合征是心肌缺血的特殊表现形式，预示着冠状动脉(冠脉)前降支近端严重狭窄，其临床症状与心电图表现不平行，常引起漏诊和误诊。本文报道1例年轻的Wellens综合征患者，因心电图呈现“伪正常化”而被忽视，在院期间经皮冠脉介入(PCI)术后Wellens综合征的类型发生转变，胸导联T波从对称性深倒置转变为正负双向改变，由Ⅰ型转换为Ⅱ型。本文对该患者的T波动态演变特点进行讨论分析，并总结Wellens综合征容易发生漏诊和误诊的原因，以此提高对Wellens综合征的认识和警惕。
- Wennlens综合征 /
- 前降支近端狭窄 /
- 心肌缺血 /
- T波动态演变
Abstract: Wellens syndrome(WS) is a special manifestation of myocardial ischemia, which indicates severe stenosis of the proximal anterior descending coronary artery. Its clinical symptoms are not consistent with the electrocardiogram(ECG) manifestations, always leading to missed diagnoses and misdiagnoses. This paper reported a young patient with WS who was overlooked due to 'pseudonormalization' displayed in ECG. During hospitalization, the type of WS changed from type Ⅰ to type Ⅱ after PCI, with the T-wave in the chest leads changing from deep symmetrical inversion to positive and negative bi-direction. In this paper, the T-wave dynamic evolution characteristics of this patient were discussed and analyzed, and the reasons why WS is prone to misdiagnosis and missed diagnosis were summarized, highlighting the need for improving awareness and vigilance towards WS.
- Wellens syndrome /
- proximal stenosis of the anterior descending artery /
- myocardial ischemia /
- dynamic change of T wave

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图 1 入院前3天急诊心电图

Figure 1. Emergency ECG 3 days before admission

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图 2 入院当天门诊心电图

Figure 2. Outpatient ECG on the day of admission

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图 3 冠状动脉造影

Figure 3. The image of coronary angiography

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图 4 PCI后心电图

Figure 4. ECG after PCI

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图 5 1个月后复查心电图

Figure 5. Follow up ECG after 1 month

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