Volume 26, Issue 130, December 2022

Timely lifesaving recanalization in two cases with De winters T wave: Case series

Gajanan N Umalkar^1♦, Charuta Gadkari², Gaurav Sahu³, Gajanan Chavan⁴, Akash Lohakare⁵

¹Department of Emergency Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be Universtiy), Wardha, India
²Department of Emergency Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be Universtiy), Wardha, India
³Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be Universtiy), Wardha, India
⁴Department of Emergency Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be Universtiy), Wardha, India
⁵Department of Cardiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be Universtiy), Wardha, India

^♦Corresponding author
Department of Emergency Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be Universtiy), Wardha, India

ABSTRACT

Acute coronary syndrome (ACS) is one of the major life-threatening conditions encountered on daily basis in the emergency department and one of the leading causes of death in middle and old age with predominant symptom as chest pain. ST elevated myocardial infarction (STEMI) can be detected early by a vital assessment tool called Electrocardiogram (ECG). De Winter T-wave ECG pattern is a rare incidence which is often unrecognized by physicians, first described by Robert J De winter and colleagues in 2008 as STEMI equivalent which signifies left anterior descending coronary artery (LAD) occlusion. This case series highlights the use of thrombolytic agents in absence of STEMI to prevent further myocardial damage and improve the patient's outcome much before percutaneous coronary intervention (PCI). Coronary revascularization on an emergency basis reestablishes coronary blood flow and reduces mortality and hospital stay. The thrombolysis was successful and the patient symptoms improved along with reversal of initial ST-segment and T-wave changes. LAD was later confirmed by coronary angiography and appropriate cardiac interventions were done.

Keywords: De winter sign, Inj. Reteplase, Thrombolysis, ACS (Acute Coronary Syndrome), Chest pain

Medical Science, 2022, 26, ms556e2637

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DOI: https://doi.org/10.54905/disssi/v26i130/ms556e2637

Published: 23 December 2022