| de Winter syndrome | |
| Synonym: | de Winter pattern, de Winter T waves, de Winter's T-waves |
| Field: | Cardiology |
| Symptoms: | Chest pain, shortness of breath |
| Onset: | Sudden |
| Causes: | Blockage of the left anterior descending artery (LAD) |
| Diagnosis: | ECG |
| Differential: | High potassium, tachycardia, benign early repolarization[1] |
| Treatment: | As per ST elevation MI (STEMI) |
| Frequency: | 2.5% of anterior MIs |
| Deaths: | High |
| Width: | 380px |
de Winter syndrome is an electrocardiogram (ECG) pattern which often represents sudden near blockage of the left anterior descending artery (LAD).[2] [3] Symptoms include chest pain, shortness of breath, and sweating.[2]
While typically due to blockage of the LAD, other arteries of the heart may be involved.[2] Risk factors are similar to other types of ischemic heart disease.[2] The underlying mechanism is unclear; though may involve subendocardial ischemia or collateral circulation.[2]
Diagnosis is based on an ECG showing ST-segment depression at the J-point of 1 to 3 mm in leads V1 to V6, with tall and symmetrical T waves.[2] The ST-segment is upsloping and there is also often ST-segment elevation of 0.5 to 2 mm in lead aVR.[2] The QRS complex is either normal or slightly wide.[2]
Treatment is as per an ST elevation MI (STEMI), with primary percutaneous coronary intervention (PCI) being preferred.[2] [4] De Winter syndrome is uncommon, representing about 2 to 3% of people with anterior MIs.[2] Males are more commonly affected than females.[2] It was first described in 2008 by Robbert J. de Winter.[2] [5]