Evaluation of acute anterior myocardial infarction cases with de-Winter T waves by coronary angiography images
Mustafa Emin Canakci1, Özge Turgay Yildirim2, Nurdan Acar3, Kadir Ugur Mert4
1Department of Emergency Medicine, Eskisehir State Hospital, Eskisehir, Turkey
2Department of Cardiology, Eskisehir State Hospital, Eskisehir, Turkey
3Department of Emergency Medicine, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
4Department of Cardiology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
Acute myocardial infarction (AMI) is the leading cause of mortality worldwide and with immediate invasive strategy, the extent of myocardial injury can be reduced. In recent studies, de-Winter T waves were defined as a sign of proximal left anterior descending artery (LAD) occlusion. In this electrocardiography (ECG) pattern, no ST elevation is seen, but an upsloping ST segment depression (>1mm) beginning from J-point, and symmetrical, long and significant T waves are seen in precordial leads.
We present three patients who were admitted to emergency department with symptoms of chest pain. Their ECGs revealed de-Winter T waves, therefore, coronary angiography was performed. Total LAD occlusion was observed in all patients, and stents were implanted to the culprit lesion.
We aim to emphasize the importance of de-Winter T waves since physicians should recognize this ECG pattern immediately in emergency situations to provide appropriate treatment to STEMI patients.