PMID- 32384494
OWN - NLM
STAT- MEDLINE
DCOM- 20200601
LR  - 20220414
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 99
IP  - 19
DP  - 2020 May
TI  - A rare transitory change of the De Winter ST/T-wave complex in a patient with 
      cardiac arrest: A case report.
PG  - e20133
LID - 10.1097/MD.0000000000020133 [doi]
LID - e20133
AB  - RATIONALE: The De Winter ST/T-wave complex is a rare and special 
      electrocardiogram (ECG) manifestation in some patients with a total or subtotal 
      occlusion in the proximal left anterior descending (LAD) coronary artery. It 
      mainly appears as an ST-segment superior oblique depression instead of an ST 
      elevation. However, a transitory change of the De Winter ST/T-wave complex has 
      not been reported previously. PATIENT CONCERNS: A 40-year-old man developed 
      sudden precordial dull and unrelieved pain. One hour later, he suddenly lost 
      consciousness when he arrived at the emergency department. After successful 
      cardiopulmonary resuscitation (CPR), 2 ECGs were taken at 22-minute interval, 
      which showed completely different manifestations. The first ECG showed acute 
      inferior-wall ST elevation myocardial infarction (STEMI), while the second ECG 
      showed a De Winter ST/T-wave complex, which indicated acute anterior-wall 
      myocardial infarction. DIAGNOSIS: The patient was diagnosed with acute myocardial 
      infarction. INTERVENTIONS: The patient responded to urgent treatment by 
      percutaneous coronary intervention (PCI). OUTCOMES: It was confirmed that the 
      case was consistent with the main characteristics of a De Winter ST/T-wave 
      complex after PCI. The first ECG was a rare transitory change of the De Winter 
      ST/T-wave complex. The patient was well recovered and discharged. LESSONS: The De 
      Winter ST/T-wave complex is an extremely dangerous and rare ECG manifestation 
      that is not widely recognized at present. Although the mechanism is not very 
      clear, it should be considered as indicating an equivalent risk of STEMI because 
      it may suggest total or subtotal occlusion in the proximal LAD coronary artery. 
      It is believed that in the near future, the mechanism of ECG including its 
      transitory changes, will be fully revealed.
FAU - Liu, Li
AU  - Liu L
AD  - Department of Cardiology of Hankou District of the General Hospital of Central 
      Theatre Command of PLA.
FAU - Wang, Dan
AU  - Wang D
AD  - Department of Ophthalmology of the General Hospital of Central Theatre Command of 
      PLA, China.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Adult
MH  - Cardiopulmonary Resuscitation/methods
MH  - Electrocardiography/*methods
MH  - Humans
MH  - Male
MH  - Non-ST Elevated Myocardial Infarction/*diagnosis/*pathology/therapy
MH  - Percutaneous Coronary Intervention/methods
PMC - PMC7220489
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2020/05/10 06:00
MHDA- 2020/06/02 06:00
PMCR- 2020/05/08
CRDT- 2020/05/09 06:00
PHST- 2020/05/09 06:00 [entrez]
PHST- 2020/05/10 06:00 [pubmed]
PHST- 2020/06/02 06:00 [medline]
PHST- 2020/05/08 00:00 [pmc-release]
AID - 00005792-202005080-00071 [pii]
AID - MD-D-19-04336 [pii]
AID - 10.1097/MD.0000000000020133 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2020 May;99(19):e20133. doi: 10.1097/MD.0000000000020133.