UMEM Educational Pearls

Title: de Winter T Waves

Keywords: de Winter T wave, proximal LAD occlusion (PubMed Search)

Posted: 11/3/2012 by Semhar Tewelde, MD (Emailed: 11/4/2012) (Updated: 11/4/2012)
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An ECG pattern that signifies occlusion of the proximal left anterior descending coronary artery (LAD) without ST-segment elevation

ST segments show a 1-3mm upsloping depression at the J point in leads V1 to V6 that continue into tall positive symmetrical T waves

QRS complexes are typically not widened or only slightly widened

Some patients also display loss of precordial R-wave progression

Most patients display 1-2mm ST-elevation in lead aVR

de Winter R, et al. A New ECG Sign of Proximal LAD Occlusion. NEJM Nov, 2008:359;19