de Winter Electrocardiographic Pattern Caused by Diagonal Branch Lesion

Area of Science:

• Cardiology
• Internal Medicine

Background:

• Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome.
• The de Winter electrocardiogram pattern typically indicates acute myocardial ischemia.

Purpose of the Study:

• To report a case of acute coronary syndrome with a de Winter electrocardiogram pattern caused by SCAD.
• To describe the transient nature of this specific ECG presentation.

Main Methods:

• Case report of a middle-aged woman presenting with chest pain.
• Electrocardiogram (ECG) monitoring and coronary angiography.
• Follow-up ECG to assess resolution of ischemic changes.

Main Results:

• The patient presented with de Winter ECG changes, indicative of acute coronary syndrome.
• Coronary angiography identified a dissection in a diagonal branch artery as the cause.
• ECG abnormalities resolved spontaneously within 2 hours without intervention.

Conclusions:

• SCAD can present with the de Winter ECG pattern, mimicking other forms of acute coronary syndrome.
• The de Winter pattern in SCAD may be transient and resolve without specific cardiac intervention.
• This case underscores the importance of considering SCAD in the differential diagnosis of acute coronary syndromes with specific ECG findings.