Evolutionary de Winter pattern: from de Winter ECG to STEMI-A case report

Author:

Wang HaoORCID,Dai Xiao-Ce,Zhao Yun-Tao,Cheng Xiao-Hang

Abstract

Abstract Background De Winter pattern is associated with acute occlusion in the left anterior descending coronary artery combined with upsloping ST-segment depression at the J point in leads V1 through V6 without ST-segment elevation. The ECG changes in this case were illustrated by an up-sloping ST-segment depression in the V1 to V6 leads, followed by tall and symmetrical T waves. Changes from de Winter to ST-segment elevation myocardial infarction (STEMI) are rare. Case presentation Our case illustrated an evolutionary de Winter sign that changed to STEMI; the patient underwent cardiac catheterization in time. Conclusions Patients who have an electrocardiogram showing de Winter changes may require primary percutaneous coronary intervention. Emergency physicians and cardiologists should not ignore these changes.

Publisher

Springer Science and Business Media LLC

Subject

Cardiology and Cardiovascular Medicine

Reference11 articles.

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3. Zhao YT, Wang L, Yi Z. Evolvement to the de Winter electrocardiographic pattern. Am J Emerg Med. 2016;34(2):330–2.

4. Verouden NJ, Koch KT, Peters RJ, et al. Persistent precordial "hyperacute" T-waves signify proximal left anterior descending artery occlusion. Heart. 2009;95(20):1701–6.

5. Montero-Cabezas JM, van der Kley F, Karalis I, Schalij MJ. Proximal left anterior descending artery acute occlusion with an unusual electrocardiographic pattern: not everything is ST elevation. Revista Espanola de Cardiologia (English ed). 2015;68(6):541–3.

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