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.
Insights
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.
Background:
A 'STEMI equivalent' electrocardiogram (ECG) pattern reflects an acute thrombotic occlusion of a large epicardial coronary artery without ST-segment elevation. These ECG patterns are less known by caregivers.
Case Summary:
We describe the case of a 56-year-old patient suffering from acute chest pain, presenting in our emergency department with a 'de Winter' ECG pattern: an upsloping ST-segment depression with tall symmetrical T waves associated with left anterior descending artery occlusion.
Discussion:
The 'de Winter' ECG pattern, as other 'STEMI equivalent', must be recognized promptly and treated as soon as possible with emergent reperfusion by percutaneous coronary intervention.
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