[ECG pearl: transient De Winter sign]
János Tomcsányi1, Hrisula Arabadzisz1, Tamás Frész1
1Kardiológiai Osztály, Budai Irgalmasrendi Kórház Budapest, Árpád fejedelem útja 7., 1027.
Orvosi Hetilap
|October 22, 2019
Summary
The De Winter sign on an ECG indicates a proximal Left Anterior Descending artery occlusion. Prompt coronary intervention is crucial for patients presenting with this acute coronary syndrome finding.
Area of Science:
- Cardiology
- Medical Diagnostics
- Interventional Cardiology
Background:
- Acute coronary syndrome (ACS) requires rapid diagnosis and treatment.
- The De Winter sign is a rare electrocardiogram (ECG) finding associated with proximal Left Anterior Descending (LAD) artery occlusion.
Observation:
- A 42-year-old male presented with ACS and the De Winter ECG sign.
- The ECG findings were initially misinterpreted, leading to a 3-hour delay in treatment.
- Hyperacute T-waves and ST-depressions resolved, but cardiac biomarkers indicated myocardial injury.
Findings:
- Coronary angiography revealed a proximal thrombotic dissection of the LAD.
- The patient was successfully treated with a drug-eluting stent.
Implications:
- The De Winter sign is a critical indicator for immediate coronary intervention in ACS.
- Timely recognition and intervention can improve outcomes in patients with proximal LAD occlusion.
- Misinterpretation of rare ECG findings can lead to significant treatment delays.
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