De Winters ST-T syndrome: an early sign of STsegment elevation myocardial infarction (A case report)

Hanen Ghazali, Maroua Mabrouk, Morsi Ellouz, Syrine Keskes, Amel Ben Garfa, Monia Ngach, Sami Souissi, Ines Chermiti

Abstract

Introduction: -
pattern reflects an acute thrombotic occlusion of a large epicardial coronary artery without ST-segment elevation.
In recent studies, one of these STEMI equivalents is the de-Winter T syndrome. It is defined by an upsloping ST-segment depression (>1mm) beginning from the J-point, and is symmetrical, and long, with significant T waves seen in precordial leads. This syndrome is highly predictive for acute proximal left anterior descending artery (LAD) occlusion.
Case presentation: We reported the case of a 45-year-old patient suffering from acute chest pain, presenting in our emergency department with a 'de Winter' ECG pattern which had evolved in a few minutes, after ventricular fibrillation cardiac arrest, into an anterior STEMI. Reperfusion therapy was performed with success.
Conclusion: Prompt recognition of this atypical ECG pattern can ensure the immediate detection of evolvement to a STEMI and therefore provide appropriate urgent reperfusion therapy either with percutaneous coronary intervention (PCI) or fibrinolysis if the PCI is not available.