Clinical analysis of de Winter syndrome in six patients / 中国基层医药

ABSTRACT

Objective:To investigate the pathological characteristics, treatment timing, and prognosis of de Winter syndrome.Methods:Six patients with de Winter syndrome who received treatment in the Department of Cardiovascular Medicine, The First People's Hospital of Tianmen from July 2017 to September 2020 were included in this study. The clinical risk factors, characteristics of coronary artery lesions, electrocardiogram evolution, echocardiography, high-sensitivity troponin, and brain natriuretic peptide were evaluated. All patients were followed up for 12 months after discharge.Results:Among the six patients included, four patients underwent coronary angiography and percutaneous coronary intervention. Coronary angiography results showed that anterior descending artery lesions occurred in all patients, consisting of occlusion of the anterior descending artery in three patients and severe stenosis of the anterior descending artery in one patient. After surgery, TIMI3 blood flow recovered in all patients. Electrocardiogram showed anterior wall ST segment elevation in five patients, and anterior wall and inferior wall ST segment elevation in one patient. One patient refused to undergo coronary angiography and was discharged after conservative management with drugs. de Winter syndrome was not identified in time in one patient. The patient died after being admitted to the hospital through routine procedures. Five recovered patients were followed up for 12 months, consisting of one patient who was re-admitted because of heart failure, and four patients in whom no adverse events occurred.Conclusion:Identification of electrocardiogram manifestations of de Winter syndrome and implementation of coronary angiography and percutaneous coronary intervention as early as possible can substantially reduce mortality rate and improve long-term prognosis.