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

Abstract

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.

Keywords

• De winter pattern
• Coronary artery disease
• Acute coronary syndrome
• Left anterior descending artery
• Percutaneous coronary intervention