The ‘de Winter’ electrocardiogram pattern as a ST-elevation myocardial infarction equivalent: a case report

Abstract Background A ‘STEMI equivalent’ electrocardiogram (ECG) pattern reflects an acute thrombotic occlusion of a large epicardial coronary artery without ST-segment elevation. These ECG patterns are less known by caregivers. Case summary We describe the case of a 56-year-old patient suffering from acute chest pain, presenting in our emergency department with a ‘de Winter’ ECG pattern: an upsloping ST-segment depression with tall symmetrical T waves associated with left anterior descending artery occlusion. Discussion The ‘de Winter’ ECG pattern, as other ‘STEMI equivalent’, must be recognized promptly and treated as soon as possible with emergent reperfusion by percutaneous coronary intervention.