PMC6524423_01
Upsloping ST depression at J point in the inferior lead (de Winter sign) (red arrow) with positive T wave (yellow arrow) along with minimal ST elevation in aVR (black arrow)
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F1
At the time of presentation, his pulse rate was 48/min and systolic blood pressure was 90 mmHg. 12-lead ECG was obtained [Figure 1] that showed upsloping ST depression at J point in II, III, and aVF with positive T wave along with minimal ST elevation in aVR.
(a) 99% thrombotic occlusion seen in the mid right coronary artery. (b) After placement of drug-eluting stent
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F2
Coronary angioplasty was done with sirolimus-eluting stent (3 mm x 20 mm) [Figure 2].
ST elevation was not noted in serial electrocardiography. Post-post angioplasty resolution of De Winter pattern in inferior leads
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F3
There was complete pain resolution after angioplasty with normalization of ST segment in all leads [Figure 3].