Konuşma Bozukluğu ile Gelen ST Segment Elevasyonu Ekivalanı Olan De Winter Dalgası; Bir Vaka Raporu

Öz

Akut koroner sendrom acil koroner girişim gerektirebilen bir klinik tablodur. En önemlisi de ST elevasyonlu miyokardiyal infarktüstür. Yeni gelişen klinik çalışmalar artık ST elevasyonu olmadan ST elevasyonlu miyokardiyal infarktüs ekivalanlarını göstermektedir. De Winter dalgası 2008 yılından beri tanımlanmış ST elevasyonlu miyokard infarktüsünün ekivalanı olarak kabul görmektedir. 71 yaşında acilimize konuşma bozukluğu ve ilerleyen süreçte anjina şikayeti gelişen hastada de Winter dalgalı miyokard infarktüsü tespit ettik. Hastanın yapılan koroner anjiografisinde literatürde çok daha nadir bildirilen sirkumfleks arterdeki akut trombüs varlığını gösterdik. ST elevasyonu olmadan gelişen bu akut koroner sendromda erken tanı çok önemlidir. Hastamızda gelişen konuşma bozukluğu ve fenalaşma hissinin acilimize gelmeden önce gelişen hayati bir distritmi sonucu geliştiğini düşünmekteyiz. Flair fazdaki manyetik görüntülemedeki yaygın iskemik değişiklikler bu disritmiye bağlı beyin hipoperfüzyonundan kaynaklanabilir. Bu hastalara mutlaka koroner anjiografi planlanmalıdır.

Anahtar Kelimeler

• De Winter Dalgası
• Miyokard infarktüsü
• Konuşma Bozukluğu

Proje Numarası

None

De Winter Wave with ST Segment Elevation Equivalent with Speech Disorder; A Case Report

Öz

ABSTRACT Acute coronary syndrome is a clinical condition that may require urgent coronary intervention. The most important is myocardial infarction with ST elevation. Emerging clinical studies now show equivalents of ST elevation myocardial infarction without ST elevation. The de Winter wave has been recognized as the equivalent of the ST-elevation myocardial infarction described since 2008. A 71 year old male patient was admitted to our emergency deparment with a symptom of speech disorder and later angina. We also detected myocardial infarction with de Winter wave in the patient. In the coronary angiography of the patient, we demonstrated the presence of acute thrombus in the circumflex artery, which is much less common in the literature. Early diagnosis is very important in this acute coronary syndrome that develops without ST elevation. We think that the speech disorder and feeling of worsening in our patient progressed as a result of a vital dystrhythmia that occured before coming to our emergency deparment. Widespread ischemic changes in magnetic resonance imaging in the flair phase may be caused by brain hypoperfusion due to this dysrhythmia. Coronary angiography should be planned for these patients.

Anahtar Kelimeler

• De Winter wave
• myocardial infarction
• speech disorder

Destekleyen Kurum

None

Proje Numarası

None

Teşekkür

None

Kaynakça

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