Acute Thrombotic Occlusion of proximal Left Anterior Descending Artery without ST-elevation (de Winter sign) in Electrocardiogram: A Case Report
Abstract
Introduction: ST-elevation in precordial leads is diagnostic for acute transmural myocardial infarction (MI) related to acute occlusion of left anterior descending artery (LAD). Case presentation: In this case report, a 54-year-old man was admitted to the emergency department (ED) due to chest pain. ST-depression with tall T waves in precordial leads was detected in surface electrocardiogram (ECG). Angiography showed acute total occlusion of proximal LAD and ad hoc percutaneous coronary intervention (PCI) was performed successfully. Conclusion: This case highlights that total occlusion of LAD may present without typical ST-elevation pattern in ECG.
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2. Birnbaum Y, Drew B. The electrocardiogram in ST elevation acute myocardial infarction: correlation with coronary anatomy and prognosis. Postgrad Med J. 2003;79(935):490-504.
3. Alzand B. Precordial ST-segments elevation. Which vessel is occluded and where? Neth Heart J. 2011;19(9):399-400.
4. de Winter RJ, Verouden NJ, Wellens HJ, Wilde AA. A new ECG sign of proximal LAD occlusion. N Eng J Med. 2008;359(19):2071-3.
5. Zorzi A, Perazzolo Marra M, Migliore F, Tarantini G, Iliceto S, Corrado D. Interpretation of acute myocardial infarction with persistent ‘hyperacute T waves’ by cardiac magnetic resonance. Eur Heart J Acute Cardiovasc Care. 2012;1(4):344-8.
6. Li RA, Leppo M, Miki T, Seino S, Marbán E. Molecular basis of electrocardiographic ST-segment elevation. Circ Res. 2000;87(10):837-9.
| Files | ||
| Issue | Vol 4 No 4 (2020): Autumn (October) | |
| Section | Case (report / study) | |
| Keywords | ||
| Anterior Wall Myocardial Infarction Case Reports Electrocardiography | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Mehrpooya M, Salehi A, Sherafati A. Acute Thrombotic Occlusion of proximal Left Anterior Descending Artery without ST-elevation (de Winter sign) in Electrocardiogram: A Case Report. Front Emerg Med. 2019;4(4):e93.
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