De Winter's T waves: Difference between revisions
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==Diagnostic Features== | ==Diagnostic Features== | ||
#Precordial ST-segment depression at the J-point | #Precordial ST-segment depression at the J-point, 1-3 mm | ||
#Tall, peaked, symmetric T waves in the precordial leads | #Tall, peaked, symmetric T waves in the precordial leads | ||
#Lead aVR shows slight ST-segment elevation in most cases | #Lead aVR shows slight ST-segment elevation in most cases | ||
Revision as of 03:15, 8 March 2016
de Winter's T-waves as described below from his NEJM editorial[1]
Background
- First identified in 2008 by Dr. de Winter found a characteristic patterns in 30 of his 1532 patient database of anterior MI
- 2% of proximal LAD occlusions will have this presentation
- de Winter T-waves is a proposed STEMI-equivalent proposed by the AHA[2]
Diagnostic Features
- Precordial ST-segment depression at the J-point, 1-3 mm
- Tall, peaked, symmetric T waves in the precordial leads
- Lead aVR shows slight ST-segment elevation in most cases
Differential Diagnosis
Management
- Rapid recognition of pattern
- Cath lab activation
- Education of consultants may be necessary due to unfamiliarity
See Also
- Acute Coronary Syndrome (Main)
- ST-Elevation Myocardial Infarction (STEMI)
- Wellens' syndrome
- STEMI equivalents