Evolutionary de Winter pattern: from de Winter ECG to STEMI-A case report.

Background: De Winter pattern is associated with acute occlusion in the left anterior descending coronary artery combined with upsloping ST-segment depression at the J point in leads V through V without ST-segment elevation. The ECG changes in this case were illustrated by an up-sloping ST-segment depression in the V to V leads, followed by tall and symmetrical T waves. Changes from de Winter to ST-segment elevation myocardial infarction (STEMI) are rare.