Emergency Department ECG
Cardiac Cath Report
LM– Normal caliber, no angiographic stenosis
LAD– 100% occlusion proximal vessel
LCx- Normal caliber, no angiographic stenosis proximal vessel
RCA– Normal caliber , dorminant vessel with mild diffuse disease. PDA/ PLV patent
De Winters T Waves
- The de Winter ECG pattern is an anterior STEMI equivalent that presents without obvious ST segment elevation.
- Key diagnostic features include ST depression and peaked T waves in the precordial leads.
- The de Winter pattern is seen in ~2% of acute LAD occlusions and is under-recognised by clinicians.
- Tall, prominent, symmetric T waves in the precordial leads
- Upsloping ST segment depression >1mm at the J-point in the precordial leads
- Absence of ST elevation in the precordial leads
- ST segment elevation (0.5mm-1mm) in aVR
- “Normal” STEMI morphology may precede or follow the deWinter pattern