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De Winter T Wave

Aka: De Winter T Wave
  1. See Also
    1. Electrocardiogram in Myocardial Infarction
    2. Acute Coronary Syndrome
    3. Acute Coronary Syndrome Immediate Management
    4. Wellens Syndrome
    5. Hyperacute T Wave
  2. Epidemiology
    1. De Winter T Waves are seen in 2% of Left Anterior Descending coronary lesions
  3. Criteria
    1. Hyperacute T Waves with J Point Depression
      1. J Point depression with upsloping ST Segment AND
      2. Tall, prominent, hyperacute precordial T Waves
    2. Other findings
      1. No ST Segment Elevation in precordial leads
      2. ST Segment Elevation in aVR
  4. Interpretation
    1. Hyperacute T Waves with J Point Depression suggests acute Occlusion of the LAD Coronary Artery
  5. Differential Diagnosis
    1. See Hyperacute T Wave
    2. Hyperkalemia
    3. ST Elevation Myocardial Infarction (STEMI)
      1. T Wave widens with increased height as an early change in STEMI, often prior to ST Elevation
  6. References
    1. emDocs
      1. http://www.emdocs.net/hyperacute-t-waves/
    2. Life in the fast Lane
      1. https://litfl.com/de-winter-t-wave-ecg-library/
  7. References
    1. de Winter (2008) N Engl J Med 359(19):2071-3 +PMID:18987380

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