Uncommon culprit artery leading to atypical de winter electrocardiographic changes: a case report

Abstract

Abstract Background A subset of patients with acute coronary artery occlusion requiring emergency revascularization, does not present with the typical ECG features of ST-segment elevation myocardial infarction (STEMI).Timely identification of these atypical presentations is crucial. Case presentation This report describes a 55-year-old male patient who was admitted to the emergency department with chest pain. The electrocardiogram (ECG) recorded atypical de Winter electrocardiographic changes and their evolution. Results Coronary angiography confirmed the occlusion of the second diagonal branch (D2). The patient’s condition improved after D2 balloon angioplasty. Conclusion De Winter electrocardiographic changes can also be observed in D2 occlusions and may present with milder manifestations. Timely recognition of these changes holds significant clinical value.

Keywords

• De Winter electrocardiographic changes
• Acute coronary syndrome
• Coronary angiography
• Occlusion of the second diagonal branch (D2)