The de Winter ECG pattern: Distribution and morphology of ST depression.

Background: The reported positive predictive value (PPV) for the "de Winter ECG pattern" to predict an acute left anterior descending artery (LAD) lesion is inconsistent. Besides, the morphology of upsloping or nonupsloping ST depression (STD) may have different significance of severity and prognostication.

Methods: We searched the MEDLINE database using "de Winter" or "junctional ST-depression with tall symmetrical T-waves" or "tall T wave" or "STEMI equivalent" as the item up to March 2020.

A de Winter electrocardiographic pattern caused by left main coronary artery occlusion: A case report.

A de Winter electrocardiographic (ECG) pattern comprising precordial junctional ST depression followed by tall, positive symmetrical T waves in leads V1/V2 to V4/V6 is often concomitant with ST elevation in lead aVR. This finding strongly suggests proximal left anterior descending coronary artery occlusion. We described a patient who had the de Winter ECG pattern in leads V2 to V4 by acute left main coronary artery (LMCA) occlusion.

Different ECG patterns of left main coronary artery occlusion signifying varying degrees of ischemic severity.

Many ischemic ECG patterns are found in patients with acute left main coronary artery occlusion. We present a patient with dynamic ECG changes that corresponded to changes in his clinical symptoms and hemodynamic status. These changes signify different severity of myocardial ischemia caused by left main coronary artery disease.

PR depression with multilead ST elevation and ST depression in aVR by left circumflex artery occlusion: How to differentiate from acute pericarditis.

PR-segment depression with multilead ST-segment elevation and ST-segment depression in lead aVR are classic ECG manifestation of acute pericarditis. We present a patient, where the etiology of these ECG features was acute ST-elevation myocardial infarction due to left circumflex artery occlusion. To avoid misdiagnosis, unnecessary examinations, and inappropriate therapeutic decisions, the possibility of ST-segment elevation myocardial infarction should be kept in mind even when ECG changes typical for pericarditis are encountered in chest pain patients.

Predicting the outcome of acute pulmonary embolism by dynamic changes of the QRS complex in lead V1.

Electrocardiography can provide useful prognostic information in acute pulmonary embolism (APE). Several abnormal QRS changes in lead V1, including notched or fragmented QRS, incomplete or complete right bundle branch block (IRBBB or CRBBB) and the QR sign, which are associated with APE, are of prognostic significance. To illustrate this, we describe lead V1 QRS changes in combination with the clinical state of six APE patients.

Electrocardiographic findings of acute total occlusion associated with a sub-occlusion involving the left anterior descending and the right coronary artery.

Background: The ECG characteristics of simultaneous acute occlusion/sub-occlusion of two coronary arteries involving the left anterior descending (LAD) and right (RCA) coronary artery have been rarely described in the literature.

Methods: We present two patient cases, where one of the arteries was totally occluded and the other one had a sub-occlusion with severely limited flow to demonstrate the ECG characteristics of this severe presentation of acute coronary syndrome.

Results: Two ECG patterns suggested simultaneous occlusions of the RCA and LAD.