The de Winter pattern in a single precordial lead caused by high-grade stenosis of the proximal left anterior descending artery with plaque rupture: A case report
Zhizhou Song,
Yuehong Huo,
Qi Wu,
Xinjian Yu,
Youdong Yang,
Zejun Meng,
Xia Li
Affiliations
Zhizhou Song
Department of Cardiology, The Third People's Hospital of Datong, Datong, Shanxi 037046, China
Yuehong Huo
Department of Rheumatology, The Fifth People's Hospital of Datong, Datong, Shanxi 038300, China
Qi Wu
Department of Cardiology, The Third People's Hospital of Datong, Datong, Shanxi 037046, China
Xinjian Yu
Quantitative and Computational Biosciences Graduate Program, Baylor College of Medicine, Houston, TX 77030, USA
Youdong Yang
Department of Cardiology, The Third People's Hospital of Datong, Datong, Shanxi 037046, China
Zejun Meng
Department of Cardiology, The Third People's Hospital of Datong, Datong, Shanxi 037046, China
Xia Li
The Third Clinical College, Shanxi University of Chinese Medicine, Taiyuan, Shanxi 030024, China; Clinical Research Center, The Third People's Hospital of Datong, Datong, Shanxi 037046, China; Corresponding author. The Third Clinical College, Shanxi University of Chinese Medicine, Taiyuan, Shanxi 030024, China.
The de Winter electrocardiogram (ECG) pattern indicates severe stenosis or occlusion of the left anterior descending artery (LAD). We present a 72-year-old female with 1.5-h chest pain. Angiography and optical coherence tomography (OCT) revealed 90 % LAD stenosis with plaque rupture, but no ST-segment elevation in the precordial leads. The de Winter pattern, characterized by upsloping ST-segment depression in V1-V6, appeared only in lead V2. Following successful percutaneous coronary intervention (PCI), the de Winter pattern disappeared. This case underscores the significance of the de Winter pattern in one precordial lead, necessitating prompt angiography and PCI for improved patient outcomes.
