de Winter pattern
Pronunciation: de WIN-ter
ECG finding indicating acute LAD occlusion without typical ST elevation.
Full Definition
The de Winter pattern is a specific electrocardiographic sign of acute proximal left anterior descending (LAD) artery occlusion that presents without the classic ST-segment elevation typically seen in anterior STEMI. The pattern is characterized by upsloping ST-segment depression leading to tall, peaked T-waves in the precordial leads, particularly V2-V5. This ECG finding represents a STEMI equivalent and requires immediate percutaneous coronary intervention despite the absence of ST elevation. The de Winter pattern is seen in approximately 2% of anterior STEMIs and is associated with proximal LAD occlusion. Recognition is critical as these patients have outcomes similar to traditional STEMI patients when treated appropriately.
Usage
Usage note: Named after Dutch cardiologist Robbert de Winter; use lowercase 'de' in surname.
In Context
- "The ECG revealed a de Winter pattern consistent with acute LAD occlusion." — Emergency department consultation
- "Despite absence of ST elevation, the de Winter pattern warranted immediate catheterization." — Cardiology procedure note