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De Winter presentations and considerations: a case series

Bahram Shahri1, Mohammad Vojdanparast2, Faeze Keihanian3,4

  • 1Interventional Cardiologist, Faculty of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

Journal of Medical Case Reports
|October 10, 2022
PubMed

Insights

The de Winter electrocardiogram finding is crucial for diagnosing acute myocardial infarction. Recognizing this pattern as an ST-elevation myocardial infarction equivalent aids emergency ward risk assessment.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Electrocardiography

Background:

  • The electrocardiogram (ECG) is vital for diagnosing and assessing risk in emergency department patients with chest pain.
  • Prompt ECG interpretation is critical for timely intervention and improved patient outcomes.

Observation:

  • This study details 11 Iranian patients diagnosed with the de Winter ECG pattern.
  • Coronary artery involvement varied, including right coronary artery (4 cases), left circumflex artery (3 cases), proximal left anterior descending artery (2 cases), and middle left anterior descending artery (7 cases).
  • A specific case of a 52-year-old male is presented in detail.

Findings:

  • The de Winter ECG pattern represents a critical finding in acute coronary syndromes.
  • Specific coronary artery territories were identified as affected in the presented cases.

Implications:

  • Recognizing the de Winter ECG pattern as an ST-elevation myocardial infarction equivalent is essential for emergency physicians.
  • This recognition can lead to more accurate and rapid diagnosis of acute myocardial infarction, guiding appropriate treatment strategies.
  • Early identification of this ECG pattern can significantly impact patient management and prognosis in acute infarction scenarios.
Abstract

Keywords:
De WinterElectrocardiogramST-elevation myocardial infarction

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