de Winter syndrome and dynamic ECG evolvement

Dynamic evolvement of the de Winter ECG pattern

“…The initial ECG showed a downsloping ST-segment at the J-point, with tall, symmetrical Twaves in leads V1 to V4, together with a slight J-point elevation in the lead aVR and a depression in inferior leads Winter ECG pattern, which was exactly the opposite of our finding. Some studies have hypothesized that the dynamic evolution, as in our case, may be attributed to the gradual occlusion of the LAD artery (He et al, 2020). However, a de Winter ECG pattern associated with complete LAD occlusion has also been reported.…”

“…reported a case in which STEMI transformed to a de Winter ECG pattern, which was exactly the opposite of our finding. Some studies have hypothesized that the dynamic evolution, as in our case, may be attributed to the gradual occlusion of the LAD artery (He et al., 2020). However, a de Winter ECG pattern associated with complete LAD occlusion has also been reported.…”

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

“…A total of 51 out of 86 articles included 83 patients ( Ahmadi, KhamenehBagheri, Vojdanparast, & Jafarzadeh‐Esfehani, 2019; Canakci, Turgay, Acar, & Mert, 2018; Carr, O'Shea, & Hinfey, 2016; Carrington, Santos, Picarra, & De, 2018; Chen, Wang, & Huang, 2020; de Winter, Adams, & Amoroso, 2019; Fiol Sala, Bayés de Luna, Carrillo López, & García‐Niebla, 2015; García‐Izquierdo, Parra‐Esteban, Mirelis, & Fernández‐Lozano, 2018; Giovanni & Francesco, 2020; Goktas, Sogut, Yigit, & Kaplan, 2017; Grandjean, Degrauwe, Tessitore, & Iglesias, 2019; Hanna & Glancy, 2016; He, Liu, & Wang, 2020; Hennings & Fesmire, 2012; Karna, Chourasiya, Chaudhari, Bakrenia, & Patel, 2019; Lam, Cheung, Wai, Wong, & Tse, 2019; Li, Li, Man, Li, & Long, 2019; Lin, Wen, Wu, & Xu, 2019; Mahajan, Batra, & Gupta, 2018; Martínez‐Losas & Fernández‐Jiménez, 2016; Massobrio, Scarrone, & Valbusa, 2016; Montero Cabezas, Karalis, & Schalij, 2016; Montero‐Cabezas, van‐der‐Kley, Karalis, & Schalij, 2015; Niimi, Ooka, Shiraishi, & Fukuda, 2019; Patel, Baker, Paterick, & Tajik, 2017; Pica, Ballestrero, Pistis, & Crimi, 2016; Pranata, Huang, & Damay, 2018; Qayyum, Hemaya, Squires, & Adam, 2018; Qu, Tao, & Liu, 2019; Rao, Wang, & Zhang, 2018; Rodrigues, Gomes, Drumond, & Pereira, 2016; Samadov, Akaslan, Cincin, Tigen, & Sarı, 2014; Sunbul, Erdogan, Yesildag, & Mutlu, 2015; Thabouillot, Bouvier, & Roche, 2017; Tsutsumi & Tsukahara, 2018; Verouden et al., 2009; Viejo‐Moreno, Rubio‐Muñoz, Cabrejas‐Aparicio, & Novo‐García, 2018; Viejo‐Moreno, Rubio‐Muñoz, Cabrejas‐Aparicio, & Novo‐García, 2018; de Winter, Adams, Verouden, & de Winter, 2016; de Winter et al., 2008; Xu, Wang, Liu, & Chen, 2018; Xu, Jiang, & Feng, 2018; Xu, Lu, & Jin, …”

“…We excluded 13 patients due to poor ECG quality (de Winter et al., 2019; Viejo‐Moreno et al., 2018; de Winter et al., 2016). The remaining 70 patients included 60 patients (Ahmadi et al., 2019; Canakci et al., 2018; Carr et al., 2016; Carrington et al., 2018; Fiol Sala et al., 2015; Giovanni & Francesco, 2020; Goktas et al., 2017; Grandjean et al., 2019; Hanna & Glancy, 2016; He et al., 2020; Hennings & Fesmire, 2012; Lam et al., 2019; Li et al., 2019; Lin et al., 2019; Mahajan et al., 2018; Martínez‐Losas & Fernández‐Jiménez, 2016; Montero‐Cabezas, van‐der Kley, Karalis, & Schalij, 2015; Niimi et al., 2019; Patel et al., 2017; Pica et al., 2016; Pranata et al., 2018; Qayyum et al., 2018; Qu et al., 2019; Rao et al., 2018; Rodrigues et al., 2016; Samadov et al., 2014; Thabouillot et al., 2017; Verouden et al., 2009; Viejo‐Moreno et al., 2018; de Winter et al., 2008, 2016; Xu, Wang, et al., 2018; Xu, Jiang, et al., 2018; Xu, Lu, et al., 2019; Xu, Xu, et al., 2019; Yang et al., 2017, 2019; Zhang et al., 2019; Zhao et al., 2016; Zorzi et al., 2012), in whom the acute disease process was caused by a lesion in the LAD (LAD group), and 10 patients with another culprit artery or other etiology (non‐LAD group): two patients with first diagonal branch (D1) occlusion (Lin et al., 2019; Montero Cabezas et al., 2016), one with obtuse marginal artery (OM) occlusion (Xu, Zou, et al., 2019), one with microvascular dysfunction (MVD; Chen et al., 2020), two with right coronary artery (RCA) disease (Karna et al., 2019; Tsutsumi & Tsukahara,…”