De Winter T Wave (STEMI Equivalent)

🖥️ Watch teaching video

---

De Winter T Wave (STEMI Equivalent):

• The de Winter ECG pattern consists of an ST-segment upsloping depression of 1 to 3 millimeter in precordial leads, associated with tall, peaked T waves.
• The de Winter T waves pattern is indicative of acute LAD occlusion which warrants primary PCI.  

• If the de Winter ECG pattern is observed, it should be treated as STEMI, and immediate cathlab activation or immediate consultation with a cardiologist, is indicated.

The de Winter T-wave pattern is recognized as a STEMI equivalent, characterized by specific ECG changes that indicate acute occlusion of the LAD artery. This ECG pattern features upsloping ST-segment depression at the J-point accompanied by tall, symmetrical T waves in precordial leads, and subtle ST elevation in lead aVR. It is crucial for clinicians to identify this pattern early, as it can precede the development of classic STEMI, allowing for timely intervention such as percutaneous coronary intervention (PCI) or thrombolysis. The de Winter pattern is often under-recognized, potentially delaying necessary treatment, which emphasizes the importance of continuous ECG monitoring in patients presenting with acute coronary syndromes.