Evolutionary de Winter pattern: from de Winter ECG to STEMI-A case report
Hao Wang1, Xiao-Ce Dai2, Yun-Tao Zhao3
1Department of Coronary Care Unit, Beijing Royal Integrative Medicine Hospital, No. 1, Wangfu street, Changping District, Beijing, 102200, P.R. China. wanghao9102@163.com.
Insights
The de Winter pattern on an ECG, indicating left anterior descending artery occlusion, can rarely evolve into ST-elevation myocardial infarction (STEMI). Prompt recognition and intervention are crucial for patient outcomes.
Area of Science:
- Cardiology
- Emergency Medicine
- Electrocardiography
Background:
- The de Winter pattern is an electrocardiogram (ECG) finding associated with acute left anterior descending coronary artery occlusion.
- It is characterized by upsloping ST-segment depression in leads V1-V6 and tall, symmetrical T waves, without ST-segment elevation.
- The evolution of the de Winter pattern to ST-elevation myocardial infarction (STEMI) is a rare clinical event.
Background:
De Winter pattern is associated with acute occlusion in the left anterior descending coronary artery combined with upsloping ST-segment depression at the J point in leads V1 through V6 without ST-segment elevation. The ECG changes in this case were illustrated by an up-sloping ST-segment depression in the V1 to V6 leads, followed by tall and symmetrical T waves. Changes from de Winter to ST-segment elevation myocardial infarction (STEMI) are rare.
Case Presentation:
Our case illustrated an evolutionary de Winter sign that changed to STEMI; the patient underwent cardiac catheterization in time.
Conclusions:
Patients who have an electrocardiogram showing de Winter changes may require primary percutaneous coronary intervention. Emergency physicians and cardiologists should not ignore these changes.
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