Abstract

BURELO-LOPEZ, Guillermo et al. The «de Winter» pattern as equivalent of acute ST segment elevation myocardial infarction. Cardiovasc. metab. sci [online]. 2020, vol.31, n.2, pp.49-52.  Epub June 14, 2024. ISSN 2954-3835.  https://doi.org/10.35366/94773.

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’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’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.

Keywords : The «de Winter» pattern; electrocardiogram; acute myocardial infarction; percutaneous coronary intervention; proximal left anterior descending artery; occlusion.

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