ECG criteria

  1- to 3-mm upsloping ST-segment depression at the J point that continues into

tall, positive symmetrical T waves.

  Involves leads V1 to V6.

  Loss of precordial R-wave progression may accompany.

  1- to 2-mm ST-elevation in lead aVR may coexist.

  This pattern is seen in
2% of acute anterior wall myocardial infarction.


  N Engl J Med 2008;359:2071-2073.

Figure 1. De Winter's T wave.

ECG 1. The ECG above is from a 40 years-old man.
It was recorded at the first hour of the onset of chest pain in the emergency room.
De Winter's T waves are seen in leads V3 to V6.
R wave progression is normal in this patient.

Dr. Ahmet Uzan has donated the above ECG to our website.

Click here for a more detailed ECG