Middle aged patient presenting with chest pain and diaphoresis. Describe and interpret his ECG
Describe and interpret this ECG
ECG ANSWER and INTERPRETATION
- ST depression in V2-6, which slopes upwards and joins the ascending limb of the T wave.
- Prominent, “rocket-shaped” T waves in the precordial leads V2-5.
- Subtle ST elevation in aVR.
- This combination of ST depression with rocket-shaped T waves in the precordial leads V1-6 is referred to as the De Winter ECG pattern or “De Winter’s T waves” (also see ECG 019)
- It is becoming increasingly recognised as an anterior STEMI equivalent (~2% of LAD occlusions).
- Some authors are now recommending that this ECG pattern be treated identically to anterior STEMI, with urgent PCI or thrombolysis.