The de Winter electrocardiographic pattern evolves to ST elevation in acute total left main occlusion: A case series
Chun-Wei Liu1, Jing-Xia Zhang1, Yue-Cheng Hu1
1Department of Cardiology, Tianjin Chest Hospital, Tianjin, China.
Summary
The de Winter electrocardiogram (ECG) pattern, typically indicating proximal left anterior descending artery occlusion, can also signal acute total left main occlusion. This rare ECG finding may progress to ST elevation over several hours.
Area of Science:
- Cardiology
- Medical Diagnostics
- Emergency Medicine
Background:
- The de Winter electrocardiogram (ECG) pattern is a rare finding characterized by specific ST-segment and T-wave abnormalities in precordial leads.
- This pattern has been historically associated with proximal left anterior descending artery occlusion.
Observation:
- This study presents three cases where the de Winter ECG pattern was observed in patients with acute total left main coronary artery occlusion.
- The observed ECG changes included widespread upsloping ST-segment depressions from V2 to V6, prominently centered on V5.
Findings:
- The de Winter ECG pattern, while rare, can be an indicator of acute total left main occlusion, a critical and life-threatening condition.
- This ECG pattern may evolve to ST-elevation myocardial infarction within hours, underscoring the urgency of diagnosis and intervention.
Implications:
- Recognizing the de Winter ECG pattern in the context of left main occlusion is crucial for timely diagnosis and management.
- Early identification can lead to prompt reperfusion therapy, potentially improving outcomes in patients with this severe coronary artery occlusion.
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