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Recognising the de Winter ECG pattern - A time critical electrocardiographic diagnosis in the Emergency Department
Hasan Qayyum1, Sherif Hemaya1, Justin Squires1
1Emergency Department, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, United Kingdom.
Insights
The de Winter ECG pattern signals a critical blockage in the left anterior descending artery, often leading to heart attacks. Prompt recognition and intervention are vital for patient survival.
Area of Science:
- Cardiology
- Emergency Medicine
- Electrocardiography
Background:
- The de Winter ECG pattern is a recognized indicator of proximal left anterior descending artery occlusion.
- This pattern is a significant risk factor for anterior wall ST elevation myocardial infarction.
Abstract:
The de Winter ECG pattern is associated with proximal left anterior descending artery occlusion, being a significant risk factor for anterior wall ST elevation myocardial infarction. We present a case of a patient who attended our Emergency Department with chest pain and a prehospital ECG demonstrating transient infero-lateral lead ST segment elevation, which changed to the de Winter ECG pattern in our Emergency Department. She subsequently underwent primary PCI of the culprit lesion within the left anterior descending artery (LAD). Recognition of de Winter ECG pattern in the Emergency Department results in a time critical diagnosis for acute coronary occlusion and should be followed by emergency coronary revascularization.
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