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Challenges in Clinical Electrocardiography
September 16, 2019

de Winter Electrocardiogram Pattern—An Unusual ST-Segment Elevation Myocardial Infarction Equivalent Pattern

Author Affiliations
  • 1Department of Cardiology, Affiliated Dongyang People's Hospital of Wenzhou Medical University, Dongyang, Zhejiang Province, People’s Republic of China
JAMA Intern Med. 2019;179(11):1575-1577. doi:10.1001/jamainternmed.2019.4127

A man in his 60s with no history of cardiovascular disease presented to the emergency department with chest pain of 1 hour’s duration. He denied any infective symptoms, palpitations, dyspnea, or hemoptysis.

On arrival to the emergency department, the patient’s blood pressure was 132/84 mm Hg, pulse was irregular at an average of 90 bpm, respirations were 18 per minute, and oxygen saturation was 96% on ambient air. The patient was hemodynamically stable, and his physical examination findings were unremarkable. Results of his blood chemistry tests and complete blood cell count were within normal limits. The results of an initial troponin I test were normal. An electrocardiogram (ECG) was obtained (Figure 1A).

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