De Winter's ECG: Not your usual STEMI

J Electrocardiol. 2024 Jul-Aug:85:46-49. doi: 10.1016/j.jelectrocard.2024.05.104. Epub 2024 Jun 3.

Abstract

We report a 39-year-old male who presented with severe chest pain and diaphoresis who suffered from pulseless polymorphic ventricular tachycardia en route to the hospital. His initial electrocardiogram showed De Winter's Pattern (dWP). Coronary angiography revealed 100% thrombotic ostial occlusion of the left anterior descending artery. In young males presenting with chest pain and diaphoresis, dWP should be part of a clinician's differential diagnosis when analyzing the initial electrocardiogram. The medical community needs increased awareness to prevent delay of revascularization because dWP is an ST-segment elevation myocardial infarction (STEMI) equivalent and does not present like a typical STEMI on electrocardiogram.

Keywords: Anterior myocardial infarction; De Winter's pattern; Left anterior descending coronary artery; ST-segment elevation myocardial infarction.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Chest Pain / etiology
  • Coronary Angiography
  • Diagnosis, Differential
  • Electrocardiography*
  • Humans
  • Male
  • ST Elevation Myocardial Infarction* / diagnosis
  • Tachycardia, Ventricular / diagnosis
  • Tachycardia, Ventricular / physiopathology