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

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

Résumé

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.