The 'de Winter' electrocardiogram pattern as a ST-elevation myocardial infarction equivalent: a case report.
Thierry Grandjean1, Sophie Degrauwe1, Elena Tessitore1
1Department of Cardiology, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.
European Heart Journal. Case Reports
|January 9, 2020
Summary
The de Winter electrocardiogram (ECG) pattern indicates a critical coronary artery blockage. Prompt recognition and treatment, such as percutaneous coronary intervention, are crucial for positive patient outcomes.
Area of Science:
- Cardiology
- Emergency Medicine
- Diagnostic Electrocardiography
Background:
- STEMI equivalent ECG patterns signify acute coronary artery occlusion without ST-segment elevation.
- These critical diagnostic patterns are often underrecognized by healthcare providers.
- Early identification is key for timely intervention in acute cardiac events.
Observation:
- A case report details a 56-year-old patient presenting with acute chest pain.
- The patient exhibited a de Winter ECG pattern: upsloping ST depression with tall, symmetrical T waves.
- This specific ECG finding was associated with occlusion of the left anterior descending artery.
Findings:
- The de Winter ECG pattern is a recognized STEMI equivalent.
- This pattern necessitates immediate clinical attention and diagnostic workup.
- The case highlights a specific presentation of acute coronary syndrome.
Implications:
- Prompt recognition of the de Winter ECG pattern is vital for patient survival.
- Emergent reperfusion therapy, including percutaneous coronary intervention, should be considered.
- Increased awareness among clinicians can improve management of acute thrombotic occlusions.
Related Concept Videos
01:29Electrocardiogram
5.1K
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
5.1K
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
308
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
308
01:30Acute Coronary Syndrome I: Introduction
637
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
637
01:28Electrocardiogram Fundamentals
1.3K
Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
1.3K
01:30Acute Coronary Syndrome III: Diagnostic Studies
162
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
162
01:30Dysrhythmias V: Evaluating Dysrhythmias
255
Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
255