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De Winter syndrome

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Tzimas, Georgios; Antiochos, Panagiotis; Monney, Pierre; Eeckhout, Eric; Meier, David; Fournier, Stephane; Harbaoui, Brahim; Muller, Olivier; Schläpfer, Jürg (October 2019). "Atypical Electrocardiographic Presentations in Need of Primary Percutaneous Coronary Intervention".
226:(PCI) being preferred. De Winter syndrome is uncommon, representing about 2 to 3% of people with anterior MIs. Males are more commonly affected than females. It was first described in 2008 by Robbert J. de Winter. 1176: 817: 223: 507: 1234: 551: 1229: 1038: 875: 1043: 1033: 622: 1340: 1171: 785: 1211: 188:
While typically due to blockage of the LAD, other arteries of the heart may be involved. Risk factors are similar to other types of
1590: 1206: 377:"Is early invasive management as ST elevation myocardial infarction warranted in de Winter's sign?-a "peak" into the widow-maker" 1075: 856: 174: 97: 1151: 1146: 1070: 870: 1497: 1373: 1302: 1134: 349: 1492: 1285: 1268: 1201: 1121: 500: 1335: 780: 130: 1317: 805: 790: 1092: 1395: 1060: 987: 714: 476: 319: 1345: 1519: 1275: 1065: 962: 943: 773: 546: 192:. The underlying mechanism is unclear; though may involve subendocardial ischemia or collateral circulation. 1552: 1526: 1514: 1502: 1487: 1221: 1163: 967: 948: 600: 540: 493: 1141: 1107: 1050: 1028: 850: 832: 768: 635: 588: 516: 189: 117: 905: 900: 795: 605: 219: 141: 1401: 929: 910: 810: 721: 664: 1406: 1263: 1258: 1181: 1085: 1055: 1014: 640: 557: 182: 110: 78: 207:. The ST-segment is upsloping and there is also often ST-segment elevation of 0.5 to 2 mm in 1509: 1307: 1129: 1080: 705: 652: 562: 452: 69: 1569: 1420: 1378: 1293: 1111: 1009: 726: 669: 567: 444: 408: 287: 170: 105: 57: 1542: 1434: 1327: 1023: 436: 398: 388: 1564: 956: 937: 924: 731: 610: 480: 1557: 1465: 1363: 1355: 1253: 763: 756: 743: 403: 376: 1584: 1547: 1458: 593: 456: 1479: 1453: 1297: 1245: 918: 894: 864: 841: 710: 700: 122: 440: 485: 1414: 1312: 1102: 1019: 1001: 827: 800: 751: 692: 212: 200: 126: 1442: 992: 196: 178: 74: 62: 45: 393: 310:
Buttner, Robert; Burns, Ed; Burns, Robert Buttner and Ed (11 October 2021).
448: 412: 291: 341: 1368: 525: 208: 36: 473: 311: 1448: 1428: 583: 204: 49: 173:(ECG) pattern which often represents sudden near blockage of the 375:
Raja, JM; Nanda, A; Pour-Ghaz, I; Khouzam, RN (September 2019).
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of 1 to 3 mm in leads V1 to V6, with tall and symmetrical
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Vilela, EM; Braga, JP (January 2022). "DeWinter Pattern".
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de Winter pattern, de Winter T waves, de Winter's T-waves
1535: 1478: 1387: 1354: 1326: 1284: 1243: 1220: 1194: 1162: 1120: 1101: 1000: 986: 886: 840: 826: 742: 691: 684: 621: 576: 533: 524: 156: 148: 136: 116: 104: 92: 84: 68: 56: 26: 21: 44:ECG showing De Winter syndrome with upsloping 501: 8: 474:Further examples from Life in the Fast Lane 277: 275: 273: 271: 269: 267: 265: 263: 261: 259: 1117: 997: 837: 818:Arrhythmogenic right ventricular dysplasia 688: 530: 508: 494: 486: 257: 255: 253: 251: 249: 247: 245: 243: 241: 239: 224:primary percutaneous coronary intervention 35: 18: 402: 392: 370: 368: 366: 305: 303: 301: 235: 552:Spontaneous coronary artery dissection 195:Diagnosis is based on an ECG showing 7: 876:Nonbacterial thrombotic endocarditis 322:from the original on 31 October 2021 215:is either normal or slightly wide. 1172:Accelerated idioventricular rhythm 429:The American Journal of Cardiology 14: 381:Annals of Translational Medicine 48:depression and tall symmetrical 857:Subacute bacterial endocarditis 352:from the original on 2021-05-07 175:left anterior descending artery 98:left anterior descending artery 1: 1374:Pulseless electrical activity 1303:Multifocal atrial tachycardia 1177:Catecholaminergic polymorphic 441:10.1016/j.amjcard.2019.07.027 342:"De Winter's T waves - WikEM" 316:Life in the Fast Lane • LITFL 131:benign early repolarization 1607: 1318:Wandering atrial pacemaker 865:non-infective endocarditis 806:Endocardial fibroelastosis 1396:hexaxial reference system 1341:Jervell and Lange-Nielsen 871:Libman–Sacks endocarditis 43: 34: 1276:Ventricular fibrillation 547:Coronary artery aneurysm 177:(LAD). Symptoms include 1591:Ischemic heart diseases 1553:Diastolic heart failure 1527:Athletic heart syndrome 1488:Ventricular hypertrophy 1222:Pre-excitation syndrome 1076:Left posterior fascicle 601:Acute coronary syndrome 541:Coronary artery disease 394:10.21037/atm.2019.07.19 218:Treatment is as per an 1071:Left anterior fascicle 851:infective endocarditis 636:Hibernating myocardium 517:Cardiovascular disease 190:ischemic heart disease 118:Differential diagnosis 1235:Wolff–Parkinson–White 1195:Premature contraction 1093:Adams–Stokes syndrome 796:Loeffler endocarditis 606:Myocardial infarction 1402:Right axis deviation 1364:Sudden cardiac death 722:Pericardial effusion 665:Ventricular aneurysm 152:2.5% of anterior MIs 1407:Left axis deviation 1264:Atrial fibrillation 1259:Ventricular flutter 1182:Torsades de pointes 1056:Bundle branch block 1015:Sick sinus syndrome 801:Cardiac amyloidosis 786:Tachycardia-induced 641:Myocardial stunning 589:Prinzmetal's angina 558:Coronary thrombosis 183:shortness of breath 79:shortness of breath 1510:Atrial enlargement 1308:Pacemaker syndrome 1230:Lown–Ganong–Levine 1152:Junctional ectopic 1147:AV nodal reentrant 653:Myocardial rupture 563:Coronary vasospasm 479:2021-10-31 at the 312:"De Winter T Wave" 199:depression at the 167:de Winter syndrome 22:de Winter syndrome 1578: 1577: 1570:Obstructive shock 1474: 1473: 1421:Short QT syndrome 1388:Other / ungrouped 1379:Sinoatrial arrest 1294:Ectopic pacemaker 1190: 1189: 1010:Sinus bradycardia 982: 981: 978: 977: 727:Cardiac tamponade 680: 679: 670:Dressler syndrome 568:Myocardial bridge 171:electrocardiogram 164: 163: 106:Diagnostic method 16:Medical condition 1598: 1543:Cardiac fibrosis 1435:T wave alternans 1328:Long QT syndrome 1122:Supraventricular 1118: 1051:Intraventricular 998: 838: 689: 534:Coronary disease 531: 510: 503: 496: 487: 461: 460: 435:(8): 1305–1314. 423: 417: 416: 406: 396: 372: 361: 360: 358: 357: 338: 332: 331: 329: 327: 307: 296: 295: 279: 185:, and sweating. 96:Blockage of the 52:in lead V1 to V6 39: 19: 1606: 1605: 1601: 1600: 1599: 1597: 1596: 1595: 1581: 1580: 1579: 1574: 1565:Rheumatic fever 1531: 1470: 1383: 1350: 1322: 1280: 1239: 1216: 1186: 1158: 1105: 1097: 991: 974: 882: 831: 822: 738: 732:Hemopericardium 676: 617: 611:Unstable angina 584:Angina pectoris 577:Active ischemia 572: 520: 514: 481:Wayback Machine 470: 465: 464: 425: 424: 420: 374: 373: 364: 355: 353: 340: 339: 335: 325: 323: 309: 308: 299: 281: 280: 237: 232: 220:ST elevation MI 142:ST elevation MI 17: 12: 11: 5: 1604: 1602: 1594: 1593: 1583: 1582: 1576: 1575: 1573: 1572: 1567: 1562: 1561: 1560: 1558:Cardiac asthma 1555: 1545: 1539: 1537: 1533: 1532: 1530: 1529: 1524: 1523: 1522: 1517: 1507: 1506: 1505: 1500: 1495: 1484: 1482: 1476: 1475: 1472: 1471: 1469: 1468: 1466:Strain pattern 1463: 1462: 1461: 1456: 1451: 1439: 1438: 1437: 1425: 1424: 1423: 1411: 1410: 1409: 1404: 1391: 1389: 1385: 1384: 1382: 1381: 1376: 1371: 1366: 1360: 1358: 1356:Cardiac arrest 1352: 1351: 1349: 1348: 1343: 1338: 1336:Andersen–Tawil 1332: 1330: 1324: 1323: 1321: 1320: 1315: 1310: 1305: 1300: 1290: 1288: 1282: 1281: 1279: 1278: 1273: 1272: 1271: 1261: 1256: 1254:Atrial flutter 1250: 1248: 1241: 1240: 1238: 1237: 1232: 1226: 1224: 1218: 1217: 1215: 1214: 1209: 1204: 1198: 1196: 1192: 1191: 1188: 1187: 1185: 1184: 1179: 1174: 1168: 1166: 1160: 1159: 1157: 1156: 1155: 1154: 1149: 1139: 1138: 1137: 1126: 1124: 1115: 1099: 1098: 1096: 1095: 1090: 1089: 1088: 1083: 1078: 1073: 1068: 1063: 1053: 1048: 1047: 1046: 1041: 1036: 1026: 1017: 1012: 1006: 1004: 995: 984: 983: 980: 979: 976: 975: 973: 972: 971: 970: 965: 953: 952: 951: 946: 934: 933: 932: 927: 915: 914: 913: 908: 903: 890: 888: 884: 883: 881: 880: 879: 878: 873: 861: 860: 859: 846: 844: 835: 824: 823: 821: 820: 815: 814: 813: 808: 803: 798: 793: 788: 783: 778: 777: 776: 764:Cardiomyopathy 761: 760: 759: 757:Chagas disease 748: 746: 740: 739: 737: 736: 735: 734: 729: 719: 718: 717: 708: 697: 695: 686: 682: 681: 678: 677: 675: 674: 673: 672: 667: 657: 656: 655: 645: 644: 643: 638: 627: 625: 619: 618: 616: 615: 614: 613: 608: 598: 597: 596: 591: 580: 578: 574: 573: 571: 570: 565: 560: 555: 549: 544: 537: 535: 528: 522: 521: 515: 513: 512: 505: 498: 490: 484: 483: 469: 468:External links 466: 463: 462: 418: 362: 333: 297: 234: 233: 231: 228: 222:(STEMI), with 162: 161: 158: 154: 153: 150: 146: 145: 138: 134: 133: 123:High potassium 120: 114: 113: 108: 102: 101: 94: 90: 89: 86: 82: 81: 72: 66: 65: 60: 54: 53: 41: 40: 32: 31: 28: 24: 23: 15: 13: 10: 9: 6: 4: 3: 2: 1603: 1592: 1589: 1588: 1586: 1571: 1568: 1566: 1563: 1559: 1556: 1554: 1551: 1550: 1549: 1548:Heart failure 1546: 1544: 1541: 1540: 1538: 1534: 1528: 1525: 1521: 1518: 1516: 1513: 1512: 1511: 1508: 1504: 1501: 1499: 1496: 1494: 1491: 1490: 1489: 1486: 1485: 1483: 1481: 1477: 1467: 1464: 1460: 1459:ST depression 1457: 1455: 1452: 1450: 1447: 1446: 1445: 1444: 1440: 1436: 1433: 1432: 1431: 1430: 1426: 1422: 1419: 1418: 1417: 1416: 1412: 1408: 1405: 1403: 1400: 1399: 1398: 1397: 1393: 1392: 1390: 1386: 1380: 1377: 1375: 1372: 1370: 1367: 1365: 1362: 1361: 1359: 1357: 1353: 1347: 1344: 1342: 1339: 1337: 1334: 1333: 1331: 1329: 1325: 1319: 1316: 1314: 1311: 1309: 1306: 1304: 1301: 1299: 1295: 1292: 1291: 1289: 1287: 1283: 1277: 1274: 1270: 1267: 1266: 1265: 1262: 1260: 1257: 1255: 1252: 1251: 1249: 1247: 1242: 1236: 1233: 1231: 1228: 1227: 1225: 1223: 1219: 1213: 1210: 1208: 1205: 1203: 1200: 1199: 1197: 1193: 1183: 1180: 1178: 1175: 1173: 1170: 1169: 1167: 1165: 1161: 1153: 1150: 1148: 1145: 1144: 1143: 1140: 1136: 1133: 1132: 1131: 1128: 1127: 1125: 1123: 1119: 1116: 1113: 1109: 1104: 1100: 1094: 1091: 1087: 1086:Trifascicular 1084: 1082: 1079: 1077: 1074: 1072: 1069: 1067: 1064: 1062: 1059: 1058: 1057: 1054: 1052: 1049: 1045: 1042: 1040: 1037: 1035: 1032: 1031: 1030: 1027: 1025: 1021: 1018: 1016: 1013: 1011: 1008: 1007: 1005: 1003: 999: 996: 994: 989: 985: 969: 968:regurgitation 966: 964: 961: 960: 959: 958: 954: 950: 949:regurgitation 947: 945: 942: 941: 940: 939: 935: 931: 930:regurgitation 928: 926: 923: 922: 921: 920: 916: 912: 911:regurgitation 909: 907: 904: 902: 899: 898: 897: 896: 892: 891: 889: 885: 877: 874: 872: 869: 868: 867: 866: 862: 858: 855: 854: 853: 852: 848: 847: 845: 843: 839: 836: 834: 829: 825: 819: 816: 812: 809: 807: 804: 802: 799: 797: 794: 792: 789: 787: 784: 782: 779: 775: 772: 771: 770: 767: 766: 765: 762: 758: 755: 754: 753: 750: 749: 747: 745: 741: 733: 730: 728: 725: 724: 723: 720: 716: 712: 709: 707: 704: 703: 702: 699: 698: 696: 694: 690: 687: 683: 671: 668: 666: 663: 662: 661: 658: 654: 651: 650: 649: 646: 642: 639: 637: 634: 633: 632: 629: 628: 626: 624: 620: 612: 609: 607: 604: 603: 602: 599: 595: 594:Stable angina 592: 590: 587: 586: 585: 582: 581: 579: 575: 569: 566: 564: 561: 559: 556: 553: 550: 548: 545: 542: 539: 538: 536: 532: 529: 527: 523: 518: 511: 506: 504: 499: 497: 492: 491: 488: 482: 478: 475: 472: 471: 467: 458: 454: 450: 446: 442: 438: 434: 430: 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Retrieved 345: 336: 324:. Retrieved 315: 283: 217: 194: 187: 166: 165: 1346:Romano–Ward 1313:Parasystole 1212:Ventricular 1164:Ventricular 1103:Tachycardia 1020:Heart block 1002:Bradycardia 828:Endocardium 791:Restrictive 752:Myocarditis 693:Pericardium 387:(17): 412. 213:QRS complex 127:tachycardia 85:Usual onset 27:Other names 1244:Flutter / 1207:Junctional 1142:Junctional 1135:Multifocal 1108:paroxysmal 1024:Sinoatrial 993:arrhythmia 988:Conduction 744:Myocardium 356:2022-07-28 284:StatPearls 230:References 197:ST-segment 179:chest pain 75:Chest pain 63:Cardiology 46:ST-segment 1503:Pulmonary 1286:Pacemaker 957:pulmonary 938:tricuspid 774:Alcoholic 457:201172222 346:wikem.org 149:Frequency 137:Treatment 58:Specialty 1585:Category 1369:Asystole 1269:Familial 963:stenosis 944:stenosis 925:stenosis 906:stenosis 901:prolapse 623:Sequelae 526:Ischemia 477:Archived 449:31455501 413:31660311 350:Archived 320:Archived 292:32491505 209:lead aVR 70:Symptoms 769:Dilated 711:Chronic 519:(heart) 404:6787391 326:28 July 205:T waves 201:J-point 144:(STEMI) 140:As per 50:T-waves 1449:J wave 1202:Atrial 1130:Atrial 919:aortic 895:mitral 887:Valves 833:valves 685:Layers 554:(SCAD) 455:  447:  411:  401:  290:  211:. The 169:is an 157:Deaths 93:Causes 88:Sudden 1536:Other 1520:Right 1498:Right 1112:sinus 1061:Right 811:Viral 706:Acute 660:weeks 631:hours 543:(CAD) 453:S2CID 100:(LAD) 1515:Left 1493:Left 1110:and 1066:Left 648:days 445:PMID 409:PMID 328:2022 288:PMID 160:High 437:doi 433:124 399:PMC 389:doi 111:ECG 1587:: 1443:ST 1415:QT 1296:/ 1044:3° 1039:2° 1034:1° 1029:AV 1022:: 713:/ 451:. 443:. 431:. 407:. 397:. 383:. 379:. 365:^ 348:. 344:. 318:. 314:. 300:^ 286:. 238:^ 181:, 129:, 125:, 77:, 1429:T 1114:) 1106:( 990:/ 830:/ 509:e 502:t 495:v 459:. 439:: 415:. 391:: 385:7 359:. 330:. 294:.

Index


ST-segment
T-waves
Specialty
Cardiology
Symptoms
Chest pain
shortness of breath
left anterior descending artery
Diagnostic method
ECG
Differential diagnosis
High potassium
tachycardia
benign early repolarization
ST elevation MI
electrocardiogram
left anterior descending artery
chest pain
shortness of breath
ischemic heart disease
ST-segment
J-point
T waves
lead aVR
QRS complex
ST elevation MI
primary percutaneous coronary intervention

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