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Junctional ST-depression and tall symmetrical T-waves with an obtuse marginal artery occlusion: A case report

Weiwei Xu1, He Zou2, Shiwei Huang2

  • 1Department of Cardiology Medicine, Affiliated Dongyang People's Hospital of Wenzhou Medical University, Dongyang, Zhejiang Province 322100, PR China.

Journal of Electrocardiology
|March 15, 2019
PubMed

Insights

The de Winter T-wave, an unusual ECG pattern, can indicate acute myocardial infarction (STEMI) caused by obtuse marginal artery occlusion. Early recognition is crucial for timely reperfusion therapy in STEMI networks.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Diagnostic Electrocardiography

Background:

  • Acute ST-segment elevation myocardial infarction (STEMI) requires rapid diagnosis and intervention.
  • The de Winter T-wave is an uncommon electrocardiogram (ECG) finding associated with myocardial ischemia.

Observation:

  • A 54-year-old male presented with chest pain and ECG findings suggestive of STEMI, including de Winter T-waves in lateral and inferior leads.
  • Emergent coronary angiography identified an occluded obtuse marginal (OM) artery as the culprit lesion.

Findings:

  • This case highlights that the de Winter T-wave pattern can be present in acute OM artery occlusion.
  • The ECG findings were indicative of a significant coronary artery blockage.

Implications:

  • Emergency physicians and STEMI network personnel should be aware of this ECG pattern for prompt diagnosis.
  • Recognizing de Winter T-waves in STEMI facilitates urgent angiography and reperfusion, improving patient outcomes.

Keywords:
Acute coronary occlusionElectrocardiogramPercutaneous coronary interventionde Winter ECG pattern

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