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A de Winter electrocardiographic pattern caused by left main coronary artery occlusion: A case report

Zhong-Qun Zhan1, Yang Li1, Li-Hao Wu1

  • 1Department of Cardiology, Shenzhen Hospital-University of Chinese Academy of Sciences, Shenzhen, P.R. China.

The Journal of International Medical Research
|June 2, 2020
PubMed

Insights

The de Winter electrocardiogram (ECG) pattern, typically indicating left anterior descending artery occlusion, can also signal acute left main coronary artery (LMCA) occlusion. Early recognition of this ECG finding is crucial for life-saving interventions.

Area of Science:

  • Cardiology
  • Medical Diagnostics

Background:

  • The de Winter electrocardiogram (ECG) pattern is a recognized indicator of proximal left anterior descending coronary artery occlusion.
  • This ECG pattern is characterized by specific ST depression and T wave abnormalities in precordial leads, often with ST elevation in lead aVR.

Observation:

  • A case study presented a patient with an acute left main coronary artery (LMCA) occlusion exhibiting the de Winter ECG pattern in leads V2-V4.
  • The patient's ECG also displayed maximal ST depression in leads V4-V5 and inverted T waves in leads V5-V6, suggesting global subendocardial ischemia.

Findings:

  • The observed ECG findings in this patient indicated a pattern suggestive of LMCA or three-vessel coronary artery disease.
  • This presentation expands the diagnostic utility of the de Winter ECG pattern beyond proximal LAD occlusion.

Implications:

  • Early identification of this specific ECG manifestation in acute LMCA occlusion is critical for timely intervention.
  • Prompt coronary intervention in cases of acute LMCA occlusion, as suggested by this ECG pattern, can be life-saving and improve patient prognosis.

Keywords:
Acute coronary occlusionaVR ST-segment elevationde Winter ECG patterndiffuse ST-segment depressionelectrocardiogramleft main coronary artery

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