REFERENCES
1. de Winter RJ, Verouden NJW, Wellens HJJ, Wilde AAM; Interventional
Cardiology Group of the Academic Medical Center. A new ECG sign of
proximal LAD occlusion. N Engl J Med. 2008;359(19):2071-2073.
2. Goebel M, Bledsoe J, Orford JL, Mattu A, BradyWJ. A new ST-segment
elevation myocardial infarction equivalent pattern? Prominent T wave and
J-point depression in the precordial leads associated with ST-segment
elevation in lead aVR [J]. Am J Emerg Med 2014, 32(3):287.e5-287.e8.
3. Montero Cabezas JM, Karalis I, Schalij MJ. De Winter
electrocardiographic pattern related with a non-left anterior descending
coronary artery occlusion. Ann Noninvasive Electrocardiol.
2016;21(5):526-528.
4. Tsutsumi K, Tsukahara K. Is the diagnosis ST-segment elevation or
non-ST-segment elevation myocardial infarction? Circulation.
2018;138(23):2715-2717.
5. Xu W, Zou H, Huang S. Junctional ST-depression and tall symmetrical
T-waves with an obtuse marginal artery occlusion: a case report. J
Electrocardiol. 2019;54:40-42.
6. Yan GX, Antzelevitch C. Cellular basis for the electrocardiographic J
wave [J]. Circulation 1996;93:372-379.
Figure1 The patient’s initial ECG on admission. Upsloping
ST-segment elevation in lead V1 to V3, and upsloping ST-segment
depression at the J waves followed by peaked, positive T waves in lead
V4 to V6, coupled with a slight ST-segment elevation in lead aVR, and Q
waves in leads V3 and V4. There exist deep q waves (<0.04
msec) in inferior leads without ST-T changes.
Figure2 Emergent Coronary Angiographic Results at Presentation
and Resolution
A. An occlusion of the proximal-LAD with TIM-0 (white arrowhead).
B. An approximately 90% stenosis in the middle-distal site of RCA
(white arrowhead).
C. The culprit lesion (the proximal-LAD) was treated by percutaneous
coronary intervention with a drug-eluting stent with TIM-3(white
arrowhead).
Figure3The
second ECG was recorded at 2 hours after stent implantation. Abnormal Q
waves and upsloping ST-segment elevation in Leads V1 to V4, There exist
deep q waves (<0.04 msec) in inferior leads without ST-T
changes.