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Dynamic evolvement of the de Winter ECG pattern
Jian Wang1, ShuLing Diao1, Baoxin Ma1
1Department of Cardiology, Binzhou Medical University Hospital, Binzhou, China.
Insights
The de Winter electrocardiograph (ECG) pattern, linked to proximal left anterior descending artery occlusion, can dynamically evolve. Our case shows it progressing from the de Winter pattern to ST-elevation myocardial infarction (STEMI) and then normalizing.
Area of Science:
- Cardiology
- Electrocardiography
- Emergency Medicine
Background:
- The de Winter electrocardiograph (ECG) pattern is a recognized sign of proximal left anterior descending (LAD) artery occlusion.
- Historically, this ECG pattern was considered static, without significant dynamic changes.
Observation:
- Recent reports suggest the de Winter ECG pattern may evolve into or follow ST-elevation myocardial infarction (STEMI).
- This case report presents a unique dynamic evolution of the de Winter ECG pattern.
Findings:
- The observed de Winter ECG pattern progressed to STEMI.
- Following STEMI, the ECG pattern subsequently returned to normal in this patient.
Implications:
- This dynamic evolution challenges the notion of the de Winter pattern as a static ECG finding.
- Understanding this evolving pattern is crucial for accurate diagnosis and management of acute coronary syndromes.
- Highlights the importance of serial ECG monitoring in patients presenting with de Winter ECG findings.
Abstract:
The de Winter electrocardiograph (ECG) pattern in patients with chest pain is associated with occlusion of the proximal left anterior descending (LAD) artery. These patterns were once considered stable conditions, without dynamic evolution of ECG. Recently, several case reports have indicated that this ECG pattern may evolve into ST-elevation myocardial infarction (STEMI) or may follow the ECG manifestations of STEMI. However, our case report reveals a dynamic evolution from the de Winter pattern to STEMI and then to a normal ECG pattern.
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