Dynamic evolvement of the de Winter ECG pattern

Figures

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  FIGURE 1. Twelve‐lead ECG of the patient. The initial ECG showed a downsloping ST‐segment at the J‐point, with tall, symmetrical T‐waves in leads V1 to V4, together with a slight J‐point elevation in the lead aVR and a depression in inferior leads

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  FIGURE 2. Twelve‐lead ECG of the patient. The second ECG, performed approximately 4 h after the first ECG, revealed ST‐segment elevation and R‐wave loss in leads V1 to V3

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  FIGURE 3. Twelve‐lead ECG of the patient. (a): Each 1 mm on the vertical axis represents 0.1 mV. (b): Each 1 mm on the vertical axis represents 0.05 mV. The third ECG (30 min after the second ECG) before emergency coronary angiography indicated ST‐segment and T‐wave resolution in leads V1 to V3

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  FIGURE 4. Coronary angiography. The coronary angiogram showed that the proximal left anterior descending (LAD) artery was completely occluded (a, white arrow) and was successfully recanalized by the insertion of a drug‐eluting stent (b, white arrow). Collateral flows from posterior descending branches of the RCA to the LAD artery were observed (c and d, red arrow)