Evaluation of acute anterior myocardial infarction cases with de-Winter T waves by coronary angiography images

Introduction: Acute myocardial infarction (AMI) is the leading cause of mortality worldwide and with immediate invasive strategy, the extent of myocardial injury can be reduced. In recent studies, de-Winter T waves were defined as a sign of proximal left anterior descending artery (LAD) occlusion. In this electrocardiography (ECG) pattern, no ST elevation is seen, but an upsloping ST segment depression (>1mm) beginning from J-point, and symmetrical, long and significant T waves are seen in precordial leads.

Case reports: We present three patients who were admitted to emergency department with symptoms of chest pain. Their ECGs revealed de-Winter T waves, therefore, coronary angiography was performed. Total LAD occlusion was observed in all patients, and stents were implanted to the culprit lesion.

Conclusion: We aim to emphasize the importance of de-Winter T waves since physicians should recognize this ECG pattern immediately in emergency situations to provide appropriate treatment to STEMI patients.