Dynamic ECG change from de Winter to Wellens - Rare ECG change in acute coronary syndrome

Abstract

A 70-year-old male complained of chest pain. His electrocardiogram (ECG) revealed the De Winter pattern, which indicates left anterior descending artery occlusion. His symptoms spontaneously resolved within 30 min. This time, his ECG showed Wellens's sign. It is rare to see a change from De Winter to Wellens in one patient.

Learning objectives

Recognize de Winter's and Wellens' electrocardiogram (ECG) patterns as high-risk ECG for acute coronary syndrome (ACS), specifically related to left anterior descending artery lesions. Obtain serial ECGs in ACS patients to detect newly emerging changes in the coronary artery.