<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2954-3835</journal-id>
<journal-title><![CDATA[Cardiovascular and metabolic science]]></journal-title>
<abbrev-journal-title><![CDATA[Cardiovasc. metab. sci]]></abbrev-journal-title>
<issn>2954-3835</issn>
<publisher>
<publisher-name><![CDATA[Asociación Nacional de Cardiólogos de México A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2954-38352020000200049</article-id>
<article-id pub-id-type="doi">10.35366/94773</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[The «de Winter» pattern as equivalent of acute ST segment elevation myocardial infarction]]></article-title>
<article-title xml:lang="es"><![CDATA[Patrón de «de Winter» como equivalente de infarto agudo de miocardio con elevación del ST]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Burelo-López]]></surname>
<given-names><![CDATA[Guillermo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández-Valerio]]></surname>
<given-names><![CDATA[Raúl]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chagoya-Triana]]></surname>
<given-names><![CDATA[Miguel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ixta-Rojas]]></surname>
<given-names><![CDATA[Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cano-Nigenda]]></surname>
<given-names><![CDATA[Vanessa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Juárez de México  ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Juárez de México  ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Nacional de Neurología y Neurocirugía «Manuel Velasco Suárez»  ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<volume>31</volume>
<numero>2</numero>
<fpage>49</fpage>
<lpage>52</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2954-38352020000200049&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2954-38352020000200049&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2954-38352020000200049&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: We present a case of a young patient with anginal chest pain, electrocardiogram (ECG) showed «de Winter» pattern characteristics, which was first reported in 2008 by Winter et al, being so far, an atypical electrocardiographic presentation of ST elevation acute myocardial infarction (STEMI) little reported in the literature. The «de Winter» ECG pattern is characterized by high and symmetrical T waves along with J-point depression in all precordial leads, associated with proximal left anterior descending artery (LAD) occlusion. In this patient, the best treatment was emergency coronary angiography with primary percutaneous coronary intervention (PCI) placing a LAD drug-eluting stent, with successful result, improving patient&#8217;s prognosis. Current guidelines do not take into account the «de Winter» ECG pattern as an equivalent of STEMI, however, literature reports an association with acute myocardial ischemia that endangers the patient&#8217;s life; we consider necessary to include this ECG pattern in the STEMI guidelines, in order to allow doctors in charge of emergency services become familiar with this diagnosis and to be able to offer a timely and effective treatment to patients.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: Presentamos el caso de un paciente joven con dolor torácico anginoso, con electrocardiograma (ECG) que muestra características del patrón de «de Winter», reportado por primera vez en el 2008 por Winter y colaboradores. Hasta el momento es una presentación electrocardiográfica atípica de infarto agudo de miocardio con elevación del segmento ST (IAMCESST) poco reportada en la literatura. Las características de este patrón encontradas en el ECG son ondas T altas y simétricas, asociadas con depresión del punto J en todas las derivaciones precordiales; este tipo de patrón se asocia a oclusión del segmento proximal de la arteria descendente anterior (DA). El tratamiento correcto en este caso fue la realización de angioplastia coronaria percutánea con colocación de stent liberador de fármaco a la DA, con resultado exitoso, lo que mejoró la supervivencia del paciente. Las guías actuales no toman en cuenta este patrón electrocardiográfico como equivalente de IAMCESST; no obstante, los reportes de la literatura lo asocian a isquemia miocárdica aguda, que pone en peligro la vida del paciente; consideramos necesario incluir este patrón electrocardiográfico en las guías de IAMCESST y, de esta manera, permitir a los médicos a cargo de los servicios de urgencias familiarizarse con este diagnóstico y ser capaces de ofrecer un tratamiento oportuno y efectivo para los pacientes.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[The «de Winter» pattern]]></kwd>
<kwd lng="en"><![CDATA[electrocardiogram]]></kwd>
<kwd lng="en"><![CDATA[acute myocardial infarction]]></kwd>
<kwd lng="en"><![CDATA[percutaneous coronary intervention]]></kwd>
<kwd lng="en"><![CDATA[proximal left anterior descending artery]]></kwd>
<kwd lng="en"><![CDATA[occlusion]]></kwd>
<kwd lng="es"><![CDATA[Patrón de «de Winter»]]></kwd>
<kwd lng="es"><![CDATA[electrocardiograma]]></kwd>
<kwd lng="es"><![CDATA[infarto agudo de miocardio]]></kwd>
<kwd lng="es"><![CDATA[intervención coronaria percutánea]]></kwd>
<kwd lng="es"><![CDATA[segmento proximal de la arteria descendente anterior]]></kwd>
<kwd lng="es"><![CDATA[oclusión]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ibanez]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[James]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Agewall]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Antunes]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Bucciarelli-Ducci]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bueno]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[European Society of Cardiology. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation]]></article-title>
<source><![CDATA[Eur Heart J]]></source>
<year>2018</year>
<volume>39</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>119-77</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Babken]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Lukas]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Negar]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Electrocardiographic diagnosis of life-threatening STEMI equivalents]]></article-title>
<source><![CDATA[J Am Coll Cardiol Case Rep]]></source>
<year>2019</year>
<volume>1</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>666-8</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carrington]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[AR]]></given-names>
</name>
<name>
<surname><![CDATA[Picarra]]></surname>
<given-names><![CDATA[BC]]></given-names>
</name>
<name>
<surname><![CDATA[Pais]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Winter pattern: a forgotten of acute LAD artery occlusion]]></article-title>
<source><![CDATA[BMJ Case Rep]]></source>
<year>2018</year>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[De Winter]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Verouden]]></surname>
<given-names><![CDATA[NJW]]></given-names>
</name>
<name>
<surname><![CDATA[Wellens]]></surname>
<given-names><![CDATA[HJJ]]></given-names>
</name>
<name>
<surname><![CDATA[Wilde]]></surname>
<given-names><![CDATA[AAM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Interventional cardiology group of the academic medical center. a new ECG sign of proximal LAD occlusion]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2008</year>
<volume>359</volume>
<numero>19</numero>
<issue>19</issue>
<page-range>2071-3</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Xu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The de winter electrocardiogram pattern is a transient electrocardiographic phenomenon that presents at the early stage of ST-segment elevation myocardial infarction]]></article-title>
<source><![CDATA[Clin Cardiol]]></source>
<year>2018</year>
<volume>41</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1177-84</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Grandjean]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Degrauwe]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Tessitore]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Iglesias]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The &#8216;de Winter&#8217; electrocardiogram pattern as a ST-elevation myocardial infarction equivalent: a case report]]></article-title>
<source><![CDATA[Eur Heart J Case Rep]]></source>
<year>2019</year>
<volume>3</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>1-5</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Raja]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Nanda]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Pour-Ghaz]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Khouzam]]></surname>
<given-names><![CDATA[RN]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Is early invasive management as ST elevation myocardial infarction warranted in de Winter&#8217;s sign-a &#8220;peak&#8221; into the widow-maker]]></article-title>
<source><![CDATA[Ann Transl Med]]></source>
<year>2019</year>
<volume>7</volume>
<numero>17</numero>
<issue>17</issue>
<page-range>412</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lam]]></surname>
<given-names><![CDATA[RPK]]></given-names>
</name>
<name>
<surname><![CDATA[Cheung]]></surname>
<given-names><![CDATA[ACK]]></given-names>
</name>
<name>
<surname><![CDATA[Wai]]></surname>
<given-names><![CDATA[AKC]]></given-names>
</name>
<name>
<surname><![CDATA[Wong]]></surname>
<given-names><![CDATA[RTM]]></given-names>
</name>
<name>
<surname><![CDATA[Tse]]></surname>
<given-names><![CDATA[TS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The de Winter ECG pattern occurred after ST-segment elevation in a patient with chest pain]]></article-title>
<source><![CDATA[Intern Emerg Med]]></source>
<year>2019</year>
<volume>14</volume>
<page-range>807-9</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Xu]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Lu]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Jin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[de Winter electrocardiogram pattern-an unusual ST-segment elevation myocardial infarction equivalent pattern]]></article-title>
<source><![CDATA[JAMA Intern Med]]></source>
<year>2019</year>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fiol Sala]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bayés de Luna]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Carrillo Lópepz]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[García-Niebla]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The &#8220;De Winter Pattern&#8221; can progress to ST-segment elevation acute coronary syndrome]]></article-title>
<source><![CDATA[Rev Esp Cardiol]]></source>
<year>2015</year>
<volume>68</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1042-3</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
