De Winter's T waves

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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

  1. Precordial ST-segment depression at the J-point
  2. Tall, peaked, symmetric T waves in the precordial leads
  3. 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

External Links

What are “de Winter T-waves”?

Sources

  1. ↑ de Winter R, et al. A new ECG sign of proximal LAD occlusion. NEJM. 2008; 359:2071–2073.
  2. ↑ Rokos I, et al. Appropriate cardiac cath lab activation: optimizing electrocardiogram interpretation and clinical decision-making for acute ST-elevation myocardial infarction. Am Heart J. 2010;160:995–1003.
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