The De Winter‐like electrocardiogram pattern associated with multi‐vessel disease

BACKGROUND: The de Winter ECG pattern was described by upsloping ST‐segment depression in leads V1‐V6, tall and symmetrical T waves in precordial leads. The ECG pattern is regarded to be associated with occlusion of the left anterior descending (LAD) artery. METHODS: One patient with de Winter ECG pattern was included. The 12‐lead ECG of patients with chest pain showed upsloping ST‐segment depression up to 3 mm at the J point in leads V2‐V6; tall symmetrical T waves in leads V2‐V4; 1mm J point elevation in lead aVR; ST‐segment depression 1mm in I, aVL leads and inverted T waves in the inferior leads. The ECG was showed the de Winter pattern. RESULTS: The ECG was showed the de Winter pattern. CAG was performed, which showed the normal left main; 60%‐80% LAD stenosis; 50%‐60% ostial right coronary artery(RCA) stenosis; and 90% stenosis of the vessel at middle segment. Both proximal and middle RCA vascular lesions were dilated and successfully inserted with drug‐eluting stents, respectively. CONCLUSION: Our case the ECG was showed horizontal ST depression with tall T waves in leads V2‐V4 (maximal ST depression in lead V4) while only ST depression in leads V5‐V6, which may result from multivessel disease.