The de Winter-Wellens Continuum: Evidence of Dynamic Bidirectional Coronary Collateral Flow in Acute Coronary

Jan Mohd Sheikh1, Khawar Achakzai1, Sameer Purra1

  • 1Department of Cardiology Sheri-Kashmir Institute of Medical Sciences Srinagar, Jammu and Kashmir, India.

JACC. Case Reports
|March 24, 2026
PubMed

Insights

A de Winter electrocardiogram (ECG) pattern evolved to a Wellen pattern in a patient with acute coronary syndrome, indicating critical left anterior descending artery disease and highlighting dynamic collateral flow influencing intervention strategy.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Emergency Medicine

Background:

  • The de Winter and Wellen patterns on electrocardiograms (ECGs) indicate critical left anterior descending artery (LAD) lesions.
  • These ECG findings necessitate urgent percutaneous coronary intervention (PCI).
Abstract

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