Key result
Prompt recognition of the de Winter sign enables successful emergent PCI for proximal LAD occlusion.
Why the study?
The de Winter sign is a recognized STEMI equivalent representing acute proximal LAD occlusion that requires emergent reperfusion therapy despite the absence of classic ST-segment elevation.
Case Report (n=1)
Early recognition of the de Winter sign as a STEMI equivalent is crucial to avoid delays in reperfusion therapy for acute proximal LAD occlusion.
INTRODUCTION: de Winter sign is a well-recognized electrocardiographic pattern that represents an acute proximal left anterior descending (LAD) coronary artery occlusion. Despite the absence of a classic ST-segment elevation, it is considered an ST-segment elevation myocardial infarction equivalent and requires emergent reperfusion therapy. CASE PRESENTATION: We report the case of an older patient presenting with acute chest pain whose initial electrocardiogram demonstrated de Winter sign. Prompt recognition led to emergent coronary angiography, confirming proximal LAD occlusion, and successful percutaneous coronary intervention. His course was complicated by cardiogenic shock requiring mechanical circulatory support. DISCUSSION: This case highlights the importance of early recognition of the de Winter sign, representing acute proximal LAD occlusion despite the absence of an ST-segment elevation, to avoid delays in reperfusion therapy and improve clinical outcomes.
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Zhang et al. (2026) conducted a case report in Acute proximal left anterior descending coronary artery occlusion (de Winter sign) (n=1). Emergent coronary angiography and percutaneous coronary intervention was evaluated. Prompt recognition of the de Winter sign in 1 patient with acute chest pain led to successful emergent percutaneous coronary intervention for a proximal LAD occlusion.
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