De Winter Pattern Beyond Acute Coronary Syndromes

Non-Coronary Causes

Acute pericarditis may show ST changes that could be confused with De Winter pattern, according to the American College of Cardiology 1, 2
Left ventricular hypertrophy can cause ST-T changes that may mimic ischemic patterns, as noted by the American College of Cardiology and the European Society of Cardiology 1, 2, 3
Stress cardiomyopathy (Takotsubo) can present with ST-T changes, similar to those seen in De Winter pattern, as reported by the American College of Cardiology 1, 2
Early repolarization patterns may show some similarities to De Winter pattern, according to the American College of Cardiology 1, 2
Brugada syndrome has distinctive ECG patterns that could be confused with anterior ischemia, as noted by the American College of Cardiology 1, 2

Comparing with previous ECGs when available is recommended by the American College of Cardiology and the European Society of Cardiology 1, 3
Considering serial ECGs to detect evolution of pattern is suggested by the American College of Cardiology and the American Heart Association 1, 4
Evaluating for clinical context (chest pain characteristics, risk factors) is recommended by the European Society of Cardiology 3, 5
Using cardiac biomarkers to help differentiate causes is suggested by the European Society of Cardiology 3, 6