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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's ECG: Not your usual STEMI

Vishwajit J Tuchscherer1, Teri M Kozik1, Muhammad Waqas Choudhry2

  • 1St. Joseph's Medical Center, Stockton, CA, USA.

Journal of Electrocardiology
|June 8, 2024
PubMed

Insights

De Winter

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Electrocardiography

Background:

  • ST-segment elevation myocardial infarction (STEMI) requires prompt revascularization.
  • Typical STEMI ECG findings often guide immediate treatment.
  • De Winter's Pattern (dWP) is an underrecognized ECG finding associated with acute coronary occlusion.

Observation:

  • A 39-year-old male presented with chest pain and diaphoresis, experiencing pulseless polymorphic ventricular tachycardia.
  • Initial electrocardiogram revealed De Winter's Pattern (dWP).
  • Coronary angiography showed a 100% thrombotic occlusion of the left anterior descending artery.

Findings:

  • De Winter's Pattern (dWP) on ECG can indicate a critical coronary artery occlusion.
  • dWP is an ST-segment elevation myocardial infarction (STEMI) equivalent.
  • This pattern may not present with classic STEMI ECG changes, potentially delaying diagnosis.

Implications:

  • Increased awareness of dWP in young males with chest pain is crucial for timely diagnosis.
  • Recognizing dWP as a STEMI equivalent can prevent delays in life-saving revascularization.
  • Prompt identification and treatment of dWP can improve patient outcomes in acute myocardial infarction.

Keywords:
Anterior myocardial infarctionDe Winter's patternLeft anterior descending coronary arteryST-segment elevation myocardial infarction

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