Exam

De Winter T Wave

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De Winter T Wave

  • Epidemiology
  1. De Winter T Waves are seen in 2% of Left Anterior Descending coronary lesions
  • 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
  • Interpretation
  1. Hyperacute T Waves with J Point Depression suggests acute Occlusion of the LAD Coronary Artery
  • 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
  • References
  1. de Winter (2008) N Engl J Med 359(19):2071-3 +PMID:18987380