48 yr old male known HTN and Smoker was brought to ED with chest pain and diaphoresis. What does the ECG show?

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DE WINTER T WAVE S IN ANTERIOR LEADS. ..CLASSICALLY SEEN IN V3 AND V4.. THIS IS STEMI EQUIVALENT. IMMEDIATELY THROMBOLYSIS OR PCI DEPENDS UPON AVAILABLITY. . ST ELEVATION IN AVR MORE THAN V1. .MAY B LMCA OCCLUSION. .

agree with ur diagnosis don't think de winter T waves suggest Left main disease, infact Left main is to be excluded and then one can call it de winter T waves avr St elevation in a part of the type of ecg presentation of LAD occlusion sir, my question is is there any guideline that recommended thrombolysis of this pattern
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Ecg abnormalities ST depression in V2-5, which slopes upwards and joins the ascending limb of the T wave. Prominent, rocket-shaped T waves in the precordial leads V2-5. Subtle ST elevation in aVR. Diagnosis This combination of ST depression with rocket-shaped T waves in the precordial leads V1-6 is referred to as the De Winter ECG pattern or De Winters T waves. It is becoming increasingly recognised as an anterior STEMI equivalent (~2% of LAD occlusions). Some authors are now recommending that this ECG pattern be treated identically to anterior STEMI, with urgent PCI or thrombolysis. de winters t wave Typical De Winters T Wave Clinical Pearls The De Winter ECG pattern may evolve into (or even evolve from) a more classic STEMI pattern. De Winter waves1

In view of risk factors and clinical presentation likely to he posterior wall mi. v4R to look for Rv infarct. TropT/I Manage with fluid and otjer protocol for MI.

Isolated Posterior wall infarction V7-V9 will help to confirm

may be posterior wall might. take posterior lead ecg

posterior wall mi
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De winter's TV waves .. STEMI Equivalent.

inferior wall ischemia.anterior wall mi.

De winters sign....occlusion of LAD

nstmi ant wall mi

de winter pattern . stemi equivalent. seen in 2% of acute Lt AD . treated like stemi ie thrombolysed or urgent PCI .1st demonstrated by winter and wellen in 2008 . This pattern is under- requognised and treated.

LAD block acute.
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