Key result
De Winter ECG pattern can occur without significant coronary occlusion, signaling impaired microvascular perfusion post-PCI.
Why the study?
The De Winter ECG pattern is considered a STEMI-equivalent pattern, but due to its rarity, it remains unclear whether it can suggest other conditions.
Case Report (n=1)
The De Winter ECG pattern can occur after PCI without significant coronary artery occlusion, potentially indicating perioperative myocardial infarction from impaired microvascular perfusion.
Answers are grounded in this paper and cite their sources.
May indicate microvascular perioperative MI in post-PCI De Winter pattern without occlusion; hypothesis-generating and leaves open need for prospective validation.
RATIONALE: The De Winter electrocardiogram (ECG) pattern is considered as a ST elevated myocardial infarction (STEMI)-equivalent pattern. Due to its rare nature, it is unclear whether this ECG pattern suggests the presence of some other condition. PATIENT CONCERNS: We reported a 47-year-old man with new-onset chest discomfort several hours after the second-stage percutaneous coronary intervention (PCI). DIAGNOSES: An emergency coronary angiogram (CAG) did not show any abnormality. However, the dynamic changes in the ECG and myocardial biomarkers indicated perioperative myocardial infarction. INTERVENTION: The patient was monitored in the cardiac care unite (CCU), and was administered an intravenous infusion of diltiazem and subcutaneous injection of low molecular weight heparin. OUTCOMES: After a few hours, his symptoms were alleviated. The patient was discharged after 6 days of hospitalization without any complications. LESSONS: The De Winter ECG pattern can be observed in patients without significantly coronary arteries occlusion. The newly onset De Winter ECG pattern after PCI procedure may indicate perioperative myocardial infarction caused by impaired microvascular perfusion.
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Chen et al. (2020) conducted a case report in De Winter electrocardiogram pattern / perioperative myocardial infarction (n=1). Intravenous infusion of diltiazem and subcutaneous injection of low molecular weight heparin was evaluated on Alleviation of symptoms and discharge without complications. The De Winter ECG pattern can occur without significant coronary artery occlusion, potentially indicating perioperative myocardial infarction caused by impaired microvascular perfusion after PCI.
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