Infrequent electrocardiographic pattern of complete left anterior descending artery occlusion: The "de Winter" pattern apropos of a case
Abstract
Accurate diagnosis through the electrocardiogram (ECG) is crucial when it comes to establishing certain behavior in the presence of an acute coronary syndrome. A brief review of the literature was carried out apropos of a case of de Winter ECG pattern which is an infrequent electrocardiographic pattern of complete left anterior descending artery occlusion that, if overlooked, causes the procedures required in each case to be unnecessarily delayed. Its electrocardiographic course and subsequent follow-up are presented so as not to forget that the electrocardiogram continues to be an invaluable and powerful tool in modern cardiology.Downloads
References
1. Einthoven W. The different forms of the human electrocardiogram and their signification. Lancet. 1912;179(4622):853-61.
2. Herrick JB. Clinical features of sudden obstruction of the coronary artery. JAMA.1912;59:2015-20.
3. de Winter RJ, Verouden NJ, Wellens HJ, Wilde AA. A new ECG sign of proximal LAD occlusion. N Engl J Med. 2008;359(19):2071-3.
4. Sagie A, Sclarovsky S, Strasberg B, Kracoff O, Rechavia E, Bassevich R, et al. Acute anterior wall myocardial infarction presenting with positive T waves and without ST segment shift. Electrocardiographic features and angiographic correlation. Chest. 1989;95(6):1211-5.
5. Birnbaum Y, Sclarovsky S, Blum A, Mager A, Gabbay U. Prognostic significance of the initial electrocardiographic pattern in a first acute anterior wall myocardial infarction. Chest. 1993;103(6):1681-7.
6. Baranchuk A, Bayés-Genis A. Naming and classifying old and new ECG phenomena. CMAJ 2016;188(7):485-6.
7. Gorgels AP. Explanation for the electrocardiogram in subendocardial ischemia of the anterior wall of the left ventricle. J Electrocardiol. 2009;42(3):248-9.
8. Fiol Sala M, Bayés de Luna A, Carrillo López A, García-Niebla J. El «patrón de De Winter» puede evolucionar a síndrome coronario agudo con elevación del segmento ST. Rev Esp Cardiol. 2015;68(11):1042-3.
9. Montero-Cabezas JM, van der Kley F, Karalis I, Schalij MJ. El «patrón de De Winter» puede evolucionar a síndrome coronario agudo con elevación del segmento ST. Respuesta. Rev Esp Cardiol. 2015;68(11):1043.
10. Dressler W, Roesler H. High T waves in the earliest stage of myocardial infarction. Am Heart J. 1947;34(5):627-45.
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.