DeWinter's T-Waves
Definition
Early warning of an evolving STEMI.
History/Physical Exam
History and findings suggestive of acute coronary syndrome.
Key 12-Lead Features
- J-Point depression with up-sloping ST segments.
- Tall, prominent, symmetric T waves in the precordial leads.
- Upsloping ST segment depression > 1mm at the J-point in the precordial leads.
- Absence of ST elevation in the precordial leads.
- ST segment elevation (0.5mm-1mm) in aVR.
- “Normal” STEMI morphology may precede or follow the DeWinter pattern.
Key Treatment Points
- Patient advocacy for a cardiology consult
- Monitor for potential emerging STEMI
12 Lead ECG Samples
References
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DeWinter et al. A new ECG sign of proximal LAD occlusion. 2008. [Link]