ArticleClinical cardiology2018
The de winter electrocardiogram pattern is a transient electrocardiographic phenomenon that presents at the early stage of ST-segment elevation myocardial infarction.
Article in Clinical cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- Atypical de Winter pattern preceding anterior STEMI: clinical judgement beyond rigid ECG criteria.BMC cardiovascular disorders · 2026Article
- De Winter Is Coming: A Rare ST-Segment Elevation Myocardial Infarction (STEMI) Equivalent in an Ironman Competitor.Cureus · 2026Article
- Phenomenon of "de Winter" pattern, sign, or syndrome: A systematic scoping review and data analysis.World journal of cardiology · 2026Article
- New electrocardiographic changes as predictors of acute coronary interventions in the emergency department: a retrospective observational study.BMC cardiovascular disorders · 2025Observational
- Article
- The dynamic evolution of the de Winter ECG pattern that is easily overlooked and life-threatening: a case report and literature review.Frontiers in cardiovascular medicine · 2025Article
- Coronary Angiographic Features of de Winter Syndrome: More Than Just Occlusion of the Left Anterior Descending Artery.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2024Article
- Evolution of de Winter syndrome to Wellens syndrome: a case report and literature review.Frontiers in cardiovascular medicine · 2024Article
- De Winter electrocardiographic pattern in a young patient with acute myocardial infarction.Proceedings (Baylor University. Medical Center) · 2023Article
- Man with chest pain.Journal of the American College of Emergency Physicians open · 2022Article
- Myocardial Ischemia in Patients with COVID-19 Infection: Between Pathophysiological Mechanisms and Electrocardiographic Findings.Life (Basel, Switzerland) · 2022Review
- Rural and Female Patients with Old Myocardial Infarction Lacked Knowledge and Preventive Measures During the Beginning of the COVID-19 Epidemic in Chongqing, Southwest China.Medical science monitor : international medical journal of experimental and clinical research · 2021Article
- Cognition and progress of de Winter electrocardiogram pattern.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2021Article
- The rare presentation of the de Winter's pattern: Case report and literature review.American heart journal plus : cardiology research and practice · 2021Article
- The de Winter's pattern revisited: a case series.European heart journal. Case reports · 2020Article
- The de Winter ECG pattern: Distribution and morphology of ST depression.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2020Review
- Evolutionary de Winter pattern: from de Winter ECG to STEMI-A case report.BMC cardiovascular disorders · 2020Article
- De Winter syndrome may be an early electrocardiogram pattern of acute myocardial infarction, two cases report.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2020Article
- Long-term treatment effect of a modified jailed-balloon technique for de Winter syndrome: a case report.The Journal of international medical research · 2020Article
- de Winter's Pattern: An Unusual but Very Important Electrocardiographic Sign to Recognize.CJC open · 2020Article
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4 authors.
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Abstract
backgroundThe de Winter electrocardiogram (EKG) pattern is a novel sign that indicates left anterior descending coronary artery (LAD) occlusion in patients with chest pain. This study aimed to assess the prevalence and clinical characteristics of patients with this pattern. HYPOTHESIS: The de Winter EKG pattern is an special anterior ST-segment elevation myocardial infarction (STEMI) equivalents without obvious ST-segment elevation.
methodsThis retrospective study included all patients with anterior myocardial infarction admitted between January 2011 and December 2017. Patients were categorized into two groups: those with the de Winter EKG pattern and those with typical STEMI.
resultsOf 441 patients, 15 (3.4%) with anterior myocardial infarction had the de Winter EKG pattern. Similar to those with typical STEMI, the majority of patients with the de Winter EKG pattern had ST-segment elevation, pathologic Q wave, and absence of R wave at follow-up. The median time from recognition of this pattern until its evolution was 114 minutes. The ST-segment in leads V3R to V5R and leads V7 to V9 were normal or slightly depressed when a typical de Winter EKG pattern was noted in leads V1 to V6. The culprit lesion was mainly in the proximal LAD or the diagonal branch. Patients with this EKG pattern responded poorly to thrombolytic therapy.
conclusionsWe believe that the de Winter EKG pattern may be a sign of ischemia and presents at the early stage of STEMI rather than being an independent pattern. In patients with this pattern, a percutaneous coronary intervention rather than follow-up and thrombolytic strategy should be performed.
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