De Winter pattern: a forgotten pattern of acute LAD artery occlusion

The De Winter ECG pattern was reported as an indicator of acute left anterior descending (LAD) coronary artery occlusion and is considered an anterior ST-elevation myocardial infarction (STEMI) equivalent.1 The key diagnostic features include ST-depression and peaked T-waves in precordial leads, and...

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Bibliographic Details
Published in:BMJ case reports 2018-11, Vol.2018, p.bcr-2018-226413
Main Authors: Carrington, Mafalda, Santos, Ana Rita, Picarra, Bruno Cordeiro, Pais, João António
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Angioplasty
Cardiovascular disease
Case reports
Coronary Angiography
Coronary Occlusion - diagnostic imaging
Coronary Occlusion - physiopathology
Coronary vessels
Coronary Vessels - diagnostic imaging
Coronary Vessels - physiopathology
Electrocardiography
Female
Heart attacks
Humans
Images In
Medical imaging
Pain
Patients
Systematic review
Veins & arteries
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Summary:The De Winter ECG pattern was reported as an indicator of acute left anterior descending (LAD) coronary artery occlusion and is considered an anterior ST-elevation myocardial infarction (STEMI) equivalent.1 The key diagnostic features include ST-depression and peaked T-waves in precordial leads, and it can be seen in around 2% of patients with anterior myocardial infarction.1 2 We report a case of a 77-year-old woman with history of treated hypertension and hypercholesterolaemia. According to a systematic review published in 2017,3 De Winter pattern has a high positive predictive value (95.2%–100%) for acute occlusion of LAD artery. [...]missing these high-risk ECG patterns as reversible severe ischaemia may lead to undertreatment of patients with a STEMI, and implies negative effects on morbidity and mortality.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2018-226413