{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T17:40:24Z","timestamp":1789926024037,"version":"4.0.1"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,7,6]],"date-time":"2020-07-06T00:00:00Z","timestamp":1593993600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,6]],"date-time":"2020-07-06T00:00:00Z","timestamp":1593993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>De Winter pattern is associated with acute occlusion in the left anterior descending coronary artery combined with upsloping ST-segment depression at the J point in leads V<jats:sub>1<\/jats:sub>through V<jats:sub>6<\/jats:sub>without ST-segment elevation. The ECG changes in this case were illustrated by an up-sloping ST-segment depression in the V<jats:sub>1<\/jats:sub>to V<jats:sub>6<\/jats:sub>leads, followed by tall and symmetrical T waves. Changes from de Winter to ST-segment elevation myocardial infarction (STEMI) are rare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>Our case illustrated an evolutionary de Winter sign that changed to STEMI; the patient underwent cardiac catheterization in time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients who have an electrocardiogram showing de Winter changes may require primary percutaneous coronary intervention. Emergency physicians and cardiologists should not ignore these changes.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12872-020-01611-0","type":"journal-article","created":{"date-parts":[[2020,7,6]],"date-time":"2020-07-06T13:03:52Z","timestamp":1594040632000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Evolutionary de Winter pattern: from de Winter ECG to STEMI-A case report"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7963-0539","authenticated-orcid":false,"given":"Hao","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Ce","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Tao","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Hang","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,7,6]]},"reference":[{"issue":"19","key":"1611_CR1","doi-asserted-by":"publisher","first-page":"2071","DOI":"10.1056\/NEJMc0804737","volume":"359","author":"RJ de Winter","year":"2008","unstructured":"de Winter RJ, Verouden NJ, Wellens HJ, Wilde AA. A new ECG sign of proximal LAD occlusion. N Engl J Med. 2008;359(19):2071\u20133.","journal-title":"N Engl J Med"},{"issue":"11","key":"1611_CR2","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.recesp.2015.08.002","volume":"68","author":"JM Montero-Cabezas","year":"2015","unstructured":"Montero-Cabezas JM, van der Kley F, Karalis I, Schalij MJ. The \"De Winter Pattern\" Can Progress to ST-segment Elevation Acute Coronary Syndrome. Response. Revista Espanola De Cardiologia (English ed). 2015;68(11):1043.","journal-title":"Revista Espanola De Cardiologia (English ed)"},{"issue":"2","key":"1611_CR3","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.ajem.2015.11.057","volume":"34","author":"YT Zhao","year":"2016","unstructured":"Zhao YT, Wang L, Yi Z. Evolvement to the de Winter electrocardiographic pattern. Am J Emerg Med. 2016;34(2):330\u20132.","journal-title":"Am J Emerg Med"},{"issue":"20","key":"1611_CR4","doi-asserted-by":"publisher","first-page":"1701","DOI":"10.1136\/hrt.2009.174557","volume":"95","author":"NJ Verouden","year":"2009","unstructured":"Verouden NJ, Koch KT, Peters RJ, et al. Persistent precordial \"hyperacute\" T-waves signify proximal left anterior descending artery occlusion. Heart. 2009;95(20):1701\u20136.","journal-title":"Heart"},{"issue":"6","key":"1611_CR5","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.recesp.2015.02.014","volume":"68","author":"JM Montero-Cabezas","year":"2015","unstructured":"Montero-Cabezas JM, van der Kley F, Karalis I, Schalij MJ. Proximal left anterior descending artery acute occlusion with an unusual electrocardiographic pattern: not everything is ST elevation. Revista Espanola de Cardiologia (English ed). 2015;68(6):541\u20133.","journal-title":"Revista Espanola de Cardiologia (English ed)"},{"issue":"11","key":"1611_CR6","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1016\/j.recesp.2015.07.009","volume":"68","author":"M Fiol Sala","year":"2015","unstructured":"Fiol Sala M, Bay\u00e9s de Luna A, Carrillo L\u00f3pez A, Garc\u00eda-Niebla J. The \"De Winter pattern\" can Progress to ST-segment elevation acute coronary syndrome. Revista Espanola de Cardiologia (English ed.). 2015;68(11):1042\u20133.","journal-title":"Revista Espanola de Cardiologia (English ed.)"},{"issue":"5","key":"1611_CR7","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/j.jelectrocard.2012.06.011","volume":"45","author":"Y Birnbaum","year":"2012","unstructured":"Birnbaum Y, Bay\u00e9s de Luna A, Fiol M, et al. Common pitfalls in the interpretation of electrocardiograms from patients with acute coronary syndromes with narrow QRS: a consensus report. J Electrocardiol. 2012;45(5):463\u201375.","journal-title":"J Electrocardiol"},{"issue":"9","key":"1611_CR8","first-page":"1177","volume":"41","author":"J Xu","year":"2018","unstructured":"Xu J, Wang A, Liu L, Chen Z. The de winter electrocardiogram pattern is a transient electrocardiographic phenomenon that presents at the early stage of ST-segment elevation myocardial infarction. Sep. 2018;41(9):1177\u201384.","journal-title":"Sep"},{"issue":"1","key":"1611_CR9","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1186\/s12933-018-0795-8","volume":"17","author":"C Sardu","year":"2018","unstructured":"Sardu C, Barbieri M, Balestrieri ML, et al. Thrombus aspiration in hyperglycemic ST-elevation myocardial infarction (STEMI) patients: clinical outcomes at 1-year follow-up. Cardiovasc Biabetology. 2018;17(1):152.","journal-title":"Cardiovasc Biabetology"},{"key":"1611_CR10","doi-asserted-by":"crossref","unstructured":"D'Onofrio N, Sardu C, Paolisso P, et al. MicroRNA-33 and SIRT1 influence the coronary thrombus burden in hyperglycemic STEMI patients. J Cell Physiol. 2020;235(2):1438\u201352.","DOI":"10.1002\/jcp.29064"},{"issue":"4","key":"1611_CR11","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/j.jacc.2018.10.074","volume":"73","author":"C Sardu","year":"2019","unstructured":"Sardu C, D'Onofrio N, Mauro C, Balestrieri ML, Marfella R. Thrombus Aspiration in Hyperglycemic Patients With High Inflammation Levels in Coronary Thrombus. J Am Coll Cardiol. 2019;73(4):530\u20131.","journal-title":"J Am Coll Cardiol"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-020-01611-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-020-01611-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-020-01611-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T09:43:18Z","timestamp":1723196598000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccardiovascdisord.biomedcentral.com\/articles\/10.1186\/s12872-020-01611-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,6]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1611"],"URL":"https:\/\/doi.org\/10.1186\/s12872-020-01611-0","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,6]]},"assertion":[{"value":"10 March 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 July 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable;","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication was obtained from the patient;","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"324"}}