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Uncommon culprit artery leading to atypical de winter electrocardiographic changes: a case report

Honglin Ni1, Changlin Zhai2, Haihua Pan3

  • 1Department of Electrocardiology, The First Hospital of Jiaxing Affiliated Hospital of Jiaxing University, Jiaxing, 314001, China.

BMC Cardiovascular Disorders
|September 28, 2024
PubMed

Insights

Atypical de Winter electrocardiogram changes can indicate occlusion in the second diagonal coronary artery. Prompt recognition of these subtle signs is vital for effective emergency treatment.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Diagnostic Electrocardiography

Background:

  • Acute coronary artery occlusion requires prompt revascularization.
  • Some patients lack typical ST-segment elevation myocardial infarction (STEMI) electrocardiogram (ECG) findings.
  • Early identification of atypical presentations is critical.

Observation:

  • A 55-year-old male presented with chest pain.
  • Electrocardiogram (ECG) revealed atypical de Winter changes.
  • The patient underwent coronary angiography.

Findings:

  • Coronary angiography identified a second diagonal (D2) artery occlusion.
  • De Winter ECG changes were observed in this D2 occlusion.
  • The patient improved after D2 balloon angioplasty.

Implications:

  • De Winter ECG patterns can signify D2 occlusions.
  • These occlusions may manifest with less severe symptoms.
  • Recognizing de Winter changes in D2 occlusions has significant clinical value for timely intervention.
Abstract

Keywords:
Acute coronary syndromeCoronary angiographyDe Winter electrocardiographic changesOcclusion of the second diagonal branch (D2)

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