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De Winter Sign in Inferior Leads: A Rare Presentation

Sunil Karna1, Mahendra Chourasiya1, Tanvi Chaudhari1

  • 1Department of Cardiology, Shree Krishna Hospital and Pramukhswami Medical College, Anand, Gujarat, India.

Heart Views : the Official Journal of the Gulf Heart Association
|May 31, 2019
PubMed

Insights

The De Winter sign, typically seen in anterior leads, was observed in inferior leads during an acute inferior wall myocardial infarction. This rare finding in inferior leads suggests a broader presentation of this electrocardiogram pattern.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Emergency Medicine

Background:

  • The De Winter electrocardiogram (ECG) pattern is a well-documented sign of acute myocardial infarction, predominantly observed in anterior leads.
  • Limited literature exists on the occurrence of the De Winter pattern in inferior ECG leads.

Observation:

  • A case of acute inferior wall myocardial infarction was identified.
  • The patient presented with thrombotic occlusion of the right coronary artery.
  • The classical De Winter sign was present in the inferior leads on the ECG.

Findings:

  • This case represents a rare instance of the De Winter sign manifesting in the inferior leads.
  • The ECG findings correlated with acute inferior wall myocardial infarction due to right coronary artery occlusion.

Implications:

  • Recognizing the De Winter sign in inferior leads is crucial for diagnosing inferior wall myocardial infarction.
  • This case expands the understanding of the De Winter pattern's ECG manifestations.
  • Prompt identification can lead to timely intervention for acute myocardial infarction.

Keywords:
De Winter left anterior descendingequivalent to ST-elevation myocardial infarctioninferior leads

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