PMC4631739_01
A - Surface ECG shows slightly widened QRS complexes, ST segment elevations in leads aVR, aVL, V1 and V2 in contrast to up-sloping ST-segment depressions in leads DII, DIII, aVF and V 3-6 at the J point. B - Post-op. ECG improved with some residual ST segment changes
PWKI-11-25708-g001.jpg
PMC4631739_01_PWKI-11-25708-g001.jpg
F0001
ST segment elevations in leads aVR, aVL, V1 and V2 in contrast to up-sloping ST-segment depressions in leads DII, DIII, aVF and V 3-6 at the J point (Figure 1 A), which is called de Winter sign. Subsequent urgent coronary angiography revealed almost total occlusion of the left main coronary artery (LMCA) with severe thrombus formation (Figure 2) and poor distal filling of both the left anterior descending (LAD) and circumflex (CX). ECG substantially improved, as shown in Figure 1 B.
Coronary angiography shows total occlusion of the left main coronary artery with severe thrombus formation and poor distal filling of both left anterior descending and circumflex arteries
PWKI-11-25708-g002.jpg
PMC4631739_01_PWKI-11-25708-g002.jpg
F0002
ST segment elevations in leads aVR, aVL, V1 and V2 in contrast to up-sloping ST-segment depressions in leads DII, DIII, aVF and V 3-6 at the J point (Figure 1 A), which is called de Winter sign. Subsequent urgent coronary angiography revealed almost total occlusion of the left main coronary artery (LMCA) with severe thrombus formation (Figure 2) and poor distal filling of both the left anterior descending (LAD) and circumflex (CX).