De Winter’s pattern: an unusual but very important electrocardiographic sign to recognize.

Abstract “STEMI equivalent” patterns make the diagnosis of of ST-segment elevation myocardial infarction (STEMI) very challenging. We present a case of de Winter’s pattern (dWp) in a man admitted to Emergency Room for chest pain, who developed cardiogenic shock despite successful percutaneous coronary intervention. Electrocardiograms performed at arrival, after 10 minutes and the day after the revascularization, demonstrated a dynamic and rapid evolution of dWp. Our case underlines the importance to promptly recognize dWp as “STEMI equivalent” pattern to advance the patient to a rapid reperfusion strategy and confirms the high-risk and the probably evolutive feature of this sign.