Acute MI de Winters

A 26 years old male comes to ER with complaints of severe sub sternal chest pain, radiating to jaw and left arm, from last one hour. Associated increased shortness of breath and perspiration. Patient does not have HTN or Diabetes. ECG done in ER shows characteristic changes. Diagnosis ?

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Ecg showing ST depression in 1 avl V2 to v6 .. with upright T WAVES and st elevation in avr .. s/o De Winter s t WAVE .. It's STEMI equivalent.. signifies acute LAD occlusion
Agree Dr. Vora . Need immediate PCI or thrombolysis, as it evolved to ant wall MI soon.
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de Winters T wave presentation, equivalent of Acute STEMI. The de Winter pattern is seen in~2% of acute LAD occlusionsandis under-recognised by clinicians. Diagnostic criteria : 1. Tall, prominent, symmetric T waves in the precordial leads. 2. Upsloping ST segment depression >1mm at the J-point in the precordial leads. 3. Absence of ST elevation in the precordial leads. 4. ST segment elevation (0.5mm-1mm) in aVRNormal STEMI morphology may precede or follow the deWinter pattern.
upright Twave in V1V2 suggestive of posterior wall MI .
? AWMI R/O Hyperkalemia
Acute posterior wall MI
interesting discussion
antero lateral mi
Hyperacute AWMI
AwMI.
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