[Skip to Content]
[Skip to Content Landing]
Views 10,862
Citations 0
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. Published online September 16, 2019. 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).

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×