De Winter’s Pattern - A Rare Electrocardiographic Sign of the Proximal Left Anterior Descending Artery Occlusion

Abstract

De Winter’s pattern is a rare anterior wall ST segment elevation myocardial infarction (STEMI) equivalent electrocardiogram (ECG) pattern that signifies 2% of proximal left anterior descending (LAD) coronary artery occlusion. We present a case of 48 years old male who presented in emergency room with a typical ischemic type of chest pain for 2 hours duration whose 12 lead ECG showed the typical De Winter’s pattern. The patient underwent immediate coronary angiography (CAG) which revealed 95-99% thrombotic occlusion of the proximal to mid left anterior descending artery. He underwent primary percutaneous coronary intervention (PPCI) with an Everolimus eluting stent that eventually resulted in a favorable outcome. Through this case report, we aim to highlight the importance of timely recognition of the rare ECG pattern and the role of PPCI as an optimal therapeutic option for such patients.