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The De Winter-like electrocardiogram pattern associated with multi-vessel disease

Chunfang Wang1, Hongli Yan1, Jian Wang1

  • 1Department of Cardiology, Binzhou Medical University Hospital, Binzhou City, China.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|June 30, 2022
PubMed

Insights

The de Winter ECG pattern, linked to Left Anterior Descending artery occlusion, was observed in a patient with multivessel coronary artery disease. This case highlights the pattern

Area of Science:

  • Cardiology
  • Electrocardiography
  • Interventional Cardiology

Background:

  • The de Winter electrocardiogram (ECG) pattern is characterized by specific ST-segment and T-wave abnormalities.
  • This pattern has been historically associated with acute occlusion of the Left Anterior Descending (LAD) artery.

Observation:

  • A case study involving a patient presenting with chest pain and the de Winter ECG pattern.
  • The patient's 12-lead ECG exhibited upsloping ST-segment depression in anterior leads (V2-V6), tall symmetrical T waves in V2-V4, J point elevation in aVR, and ST depression in lateral leads.
  • The ECG findings were consistent with the de Winter pattern.

Findings:

  • Coronary angiography revealed significant stenosis in the LAD (60-80%) and Right Coronary Artery (RCA) (50-60% ostial, 90% mid-segment).
  • The patient had multivessel coronary artery disease, not solely LAD occlusion.
  • Percutaneous coronary intervention with drug-eluting stents was successfully performed on the RCA lesions.

Implications:

  • The de Winter ECG pattern may indicate multivessel coronary artery disease, extending beyond isolated LAD occlusion.
  • This case underscores the importance of comprehensive ECG interpretation in patients with acute coronary syndromes.
  • Recognition of this pattern can guide timely diagnostic and therapeutic interventions in complex coronary artery disease scenarios.
Abstract

Keywords:
de Winter ECG patternmulti-vessel disease

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