A middle-aged male patient with de Winter syndrome: a case report

BMC Cardiovasc Disord. 2020 Jul 18;20(1):342. doi: 10.1186/s12872-020-01619-6.

Abstract

Background: De Winter syndrome accounts for approximately 2% of all patients with acute anterior myocardial infarction admitted to the emergency department, and is characterized by severe stenosis of the left anterior descending coronary artery (LAD). The ECG changes are not recognized by ECG software, and poor understanding of the syndrome among physicians may lead to misdiagnosis, delayed reperfusion, and mortality.

Case presentation: A 51-year-old male patient presented with a newly developed ECG pattern suggestive of de Winter Syndrome. Coronary angiography revealed anterior myocardial infarction. Based on the ECG and clinical manifestations, the patient was diagnosed with de Winter syndrome and underwent timely percutaneous coronary intervention to revascularize the left anterior descending artery (LAD). The patient showed good outcomes and no complications at 4 months after the operation.

Conclusions: This case highlights the importance of being aware of the possibility of de Winter syndrome in patients with symptoms of myocardial infarction but atypical ECG in order to conduct early revascularization and treatments.

Keywords: Electrocardiogram; Myocardial infarction; Revascularization; ST-elevated myocardial infarction.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Action Potentials*
  • Anterior Wall Myocardial Infarction / diagnosis*
  • Anterior Wall Myocardial Infarction / physiopathology
  • Anterior Wall Myocardial Infarction / therapy
  • Coronary Angiography
  • Coronary Stenosis / diagnosis*
  • Coronary Stenosis / physiopathology
  • Coronary Stenosis / therapy
  • Electrocardiography*
  • Heart Conduction System / physiopathology*
  • Heart Rate*
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / instrumentation
  • Predictive Value of Tests
  • Stents
  • Treatment Outcome