Case report of de Winter Syndrome and ST-elevation myocardial infarction

Chest pain is the presenting complaint of a myriad of illnesses, ranging from lifethreatening causes such as acute myocardial infarction (AMI) to comparatively benign causes like gastroesophageal reflux. Less than half of patients presented with chest pain suggestive of cardiac origin have classic diagnostic features in the electrocardiogram (ECG). However, identifying the elusive ECG findings of an AMI is a diagnostic challenge.
Subtle ECG changes can easily be missed unless specifically looked for. De Winter syndrome is one such diagnosis, which may evolve into ST-elevation myocardial infarction (STEMI) or vice versa. This is a case of a successfully managed 46-year-old male, who presented with suggestive chest pain and ECG evidence of de Winter syndrome.