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The rare presentation of the de Winter's pattern: Case report and literature review

Rohan Madhu Prasad1, Abdullah Al-Abcha1, Ahmed Elshafie1

  • 1Michigan State University - Sparrow Hospital, 1200 E Michigan Ave, Ste 510, Lansing, MI. 48912, United States of America.

American Heart Journal Plus : Cardiology Research and Practice
|April 1, 2024
PubMed

Insights

The de Winter ECG pattern, an STEMI equivalent, signals critical coronary artery disease. Prompt recognition and intervention, like stenting, are vital for positive outcomes.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Diagnostic Imaging

Background:

  • ST-elevation myocardial infarction (STEMI) requires immediate intervention.
  • Certain electrocardiogram (ECG) patterns, known as STEMI equivalents, also indicate urgent cardiac events.
  • The de Winter pattern is a recognized STEMI equivalent.

Purpose of the Study:

  • To highlight the significance of the de Winter ECG pattern.
  • To emphasize the need for prompt recognition and treatment of this pattern.
  • To present a case demonstrating successful intervention for de Winter pattern.

Main Methods:

  • Case report of a 50-year-old male presenting with chest pain.
  • Electrocardiogram (ECG) analysis revealing de Winter pattern characteristics.
  • Diagnostic coronary angiography to identify coronary artery occlusion.
  • Percutaneous coronary intervention (PCI) with drug-eluting stents.

Main Results:

  • The patient presented with chest pain and a de Winter ECG pattern.
  • Coronary angiography showed complete occlusion of the proximal left anterior descending (LAD) artery.
  • Successful PCI with stent placement restored arterial blood flow.
  • ECG findings normalized post-intervention.

Conclusions:

  • The de Winter ECG pattern is indicative of significant coronary artery disease.
  • This pattern necessitates urgent intervention, such as PCI.
  • Timely diagnosis and treatment are crucial for patients with de Winter pattern.

Keywords:
Case reportPercutaneous interventionSTEMI equivalentsThrombolysisde Winter's pattern

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