The De Winter ECG is sometimes seen in myocardial infarction with proximal LAD occlusion. It is rather rare (2% of cases). There is no anterior ST segment elevation. Instead the ST segment shows a 1- to 3-mm upsloping ST-segment depression at the J point in leads V1 to V6 that continues into tall, positive symmetrical T waves. The QRS complexes are usually not widened or only slightly widened, and sometimes there is a loss of precordial R-wave progression. In most patients there is a 1- to 2-mm ST-elevation in lead aVR. <cite>dewinter</cite> Prof. Robert de Winter is an intervention cardiologist in the Academic Medical Center in Amsterdam, the Netherlands.{{clr}} | The De Winter ECG is sometimes seen in myocardial infarction with proximal LAD occlusion. It is rather rare (2% of cases). There is no anterior ST segment elevation. Instead the ST segment shows a 1- to 3-mm upsloping ST-segment depression at the J point in leads V1 to V6 that continues into tall, positive symmetrical T waves. The QRS complexes are usually not widened or only slightly widened, and sometimes there is a loss of precordial R-wave progression. In most patients there is a 1- to 2-mm ST-elevation in lead aVR. <cite>dewinter</cite> Prof. Robert de Winter is an intervention cardiologist in the Academic Medical Center in Amsterdam, the Netherlands.{{clr}} |