Evolutionary de Winter pattern: from de Winter ECG to STEMI-A case report.

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 Winter to ST-segment elevation myocardial infarction (STEMI) are rare.

CASE PRESENTATION: Our case illustrated an evolutionary de Winter sign that changed to STEMI; the patient underwent cardiac catheterization in time.

CONCLUSIONS

Patients who have an electrocardiogram showing de Winter changes may require primary percutaneous coronary intervention. Emergency physicians and cardiologists should not ignore these changes.