Aslanger's and de Winter's patterns associated with acute left coronary artery disease: A case report of two patients.

Current guidelines classify acute coronary syndrome (ACS) into unstable angina (UA), ST-segment elevation myocardial infarction (STEMI), and non-ST-segment elevation myocardial infarction (NSTEMI). However, this classification pattern may lead to inadequate recognition of acute coronary occlusion (ACO), particularly when electrocardiographic (ECG) findings are atypical. An increasing number of "STEMI-equivalent" ECG patterns are considered significant features of ACO. The Aslanger's pattern is regarded as indicative of right coronary artery (RCA)-related inferior wall myocardial infarction, while the de Winter's pattern is considered an STEMI-equivalent manifestation of acute left anterior descending (LAD) occlusion. This article reports two cases of ACS patients who exhibited both Aslanger's and de Winter's patterns on admission ECG, but coronary angiography confirmed acute lesions in the left coronary artery system. The Aslanger's pattern is not a specific manifestation of RCA lesions. When co-occurring with de Winter patterns, heightened vigilance for acute left coronary artery lesions is warranted. Identifying such patterns holds significant clinical importance for avoiding delays in reperfusion therapy.