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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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de Winter syndrome or inferior STEMI?

Shijun Wang1, Liang Shen2

  • 1Department of Cardiology, Affiliated Hospital of Jiaxing University, No.1882 Zhonghuan South Road, Jiaxing, 314000, Zhejiang, People's Republic of China.

BMC Cardiovascular Disorders
|December 28, 2021
PubMed

Insights

The de Winter electrocardiography (ECG) pattern, typically linked to left anterior descending artery (LAD) occlusion, can present atypically with ST elevation. Recognizing this variant is crucial for prompt reperfusion therapy.

Area of Science:

  • Cardiology
  • Medical Diagnostics

Background:

  • The de Winter electrocardiography (ECG) pattern signifies acute total or subtotal occlusion of the left anterior descending coronary artery (LAD).
  • This pattern is classically defined by J-point upsloping ST-segment depression in precordial leads (V1-V6) without ST elevation.

Observation:

  • This case report details an unusual presentation of the de Winter ECG pattern.
  • The atypical manifestation included concurrent ST elevation in the inferior leads of the ECG.

Findings:

  • Emergency coronary angiography confirmed total occlusion of the proximal LAD in the patient.
  • No significant stenosis was identified in the right coronary artery, supporting the LAD as the primary culprit.

Implications:

  • Acute LAD occlusion can manifest with the de Winter pattern alongside inferior ST elevation, an atypical but critical ECG finding.
  • Prompt recognition of this variant ECG pattern is essential for initiating timely reperfusion therapy in patients with acute coronary syndromes.
Abstract

Keywords:
Case reportDe Winter syndromeSTEMI

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