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Case 2: A 34-year-old female presented with a 2-h history of ischaemic chest pain with initial ECG showing a de Winter's pattern. Due to concerns of performing PCI timeously, a pharmacoinvasive strategy of reperfusion was adopted with resolution of the de Winter's pattern. Urgent angiography revealed a proximal LAD lesion which was successfully.
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The De Winter ECG pattern has been reported to indicate acute left anterior descending coronary artery occlusion and is often considered to be an 'ST elevation myocardial infarction (STEMI) equivalent'.
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de winter syndrome is a rare pattern that can occur on an electrocardiogram (ECG). 1 It is thought to be related to acute anterior descending artery occlusion. 1 ST-segment elevation myocardial infarction (STEMI) equivalent patterns make the diagnosis of STEMI very challenging. 1 The ECG reveals a de Winter's pattern, which shows a 1 to 3 mm ups.
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An electrocardiographic finding suggestive of impending myocardial infarction , the de Winter's pattern (or "de Winter's T-waves") describes an abnormality thought to be indicative of acute occlusion of the proximal left anterior descending coronary artery ( LAD) 2.
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The main criteria for De Winter sign are upsloping ST-segment depression by 0.1 mV at V1-V6 leads and tall symmetrical T waves [2]. Ideally, De Winter's sign-on electrocardiography should be treated as an ST-elevation myocardial infarct (STEMI) equivalent with early cardiac catheter lab activation for percutaneous coronary intervention [2].
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de Winter syndrome is a special equivalent of anterior ST-segment elevation myocardial infarction (STEMI) characterized by the absence of overt ST-elevation with upsloping ST-segment depression followed by tall symmetrical T-waves in the precordial leads, often associated with total occlusion of the proximal left anterior descending coronary art.
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Background The electrocardiogram has a critical role in the diagnosis and risk assessment of patients presenting with chest pain in the emergency ward. Case presentation We present 11 Iranian patients with diagnosis of de Winter referred to our center. Right coronary artery involvement was seen in four cases, left circumflex artery in three cases, proximal left anterior descending artery in.
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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 V1 through V6 without ST-segment elevation. The ECG changes in this case were illustrated by an up-sloping ST-segment depression in the V1 to V6 leads, followed by tall and symmetrical T waves. Changes from de.
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de Winter syndrome is a rare phenomenon, and it occurs in approximately 2% of patients with myocardial infarction. 2 It has a high predictive value for LAD occlusion. 4 Recent studies suggested that de Winter syndrome may be a transient event before progressing into typical STEMI ECG. 5 The exact electrophysiologic mechanisms involved are not.
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↑ de Winter R, et al. A new ECG sign of proximal LAD occlusion. NEJM. 2008; 359:2071-2073. ↑ Rokos I, et al. Appropriate cardiac cath lab activation: optimizing electrocardiogram interpretation and clinical decision-making for acute ST-elevation myocardial infarction. Am Heart J. 2010;160:995-1003.
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July 4, 2015 De Winter ST/T-Waves Objective Understand and identify de Winter ST/T-waves as a STEMI equivalent De Winter ST/T-Waves ECG abnormality described by de Winter et al. in 1998 Characterized by 1-3 mm of ST-depression with upright, symmetrical T-waves Changes are dynamic as you would expect with ACS (see Example 3 below)
Winters
The de Winter pattern is seen in ~2% of acute LAD occlusions and is often under-recognised by clinicians Key diagnostic features include ST depression and peaked T waves in the precordial leads
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The de Winter's electrocardiogram (ECG) pattern signifying proximal left anterior descending (LAD) artery occlusion was first described in 2008. The ECG changes were thought to be static and mechanisms for this were suggested.
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In 2008, de Winter et al described an ECG pattern suggesting that it should be considered an ST‐elevation myocardial infarction (STEMI) equivalent (de Winter, Verouden, Wellens, & Wilde, 2008 ), with the potential to predict critical stenosis or occlusion of the left anterior descending coronary artery (LAD). This ECG pattern typically.
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Background The de Winter electrocardiography (ECG) pattern is associated with acute total or subtotal occlusion of the left anterior descending coronary artery (LAD) characterized by upsloping ST-segment depression at the J point in leads V1-V6 without ST-segment elevation. Case presentation We report an atypical style case of the de Winter ECG pattern accompanied by ST elevation in inferior.
