Why the study?
Electrocardiographic changes from a de Winter pattern to ST-segment elevation myocardial infarction are rare.
The de Winter ECG pattern can rapidly evolve into a STEMI pattern due to total occlusion of the proximal LAD, highlighting the need for prompt recognition and primary PCI.
Prompt ECG vigilance warranted for de Winter patterns; extends sparse case observations on rapid LAD occlusion but leaves broader implications open.
Background De Winter pattern is associated with acute occlusion in the left anterior descending coronary artery combined with upsloping ST-segment depression at the J point in leads V 1 through V 6 without ST-segment elevation. The ECG changes in this case were illustrated by an up-sloping ST-segment depression in the V 1 to V 6 leads, followed by tall and symmetrical T waves. Changes from de Winter to ST-segment elevation myocardial infarction (STEMI) are rare. Case presentation Our case illustrated an evolutionary de Winter sign that changed to STEMI; the patient underwent cardiac catheterization in time. Conclusions Patients who have an electrocardiogram showing de Winter changes may require primary percutaneous coronary intervention. Emergency physicians and cardiologists should not ignore these changes.
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Wang et al. (2020) studied this question.
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