Abstract: Abstract：The electrocardiogram (ECG) characteristics of some patients with acute coronary syndrome (ACS) are not typical and very susceptible to be misdiagnosed. De Winter syndrome is one of the most dangerous type of ACS, which should be considered as an equal risk of ST segment elevation myocardial infarction. Emergency coronary angiography should be urgently performed to complete revascularization as soon as possible to prevent serious adverse cardiovascular events. We report a case of a 77-year-old male patient with De Winter syndrome, whose initial complaint was acute chest pain. The result of ECG showed changes of De Winter sign. It has been associated with proximal occlusion of the left anterior descending (LAD) coronary artery, even though there was no abnormal sign of myocardial injury markers. Timely reperfusion therapy by means of primary percutaneous coronary intervention (PCI) was the preferred treatment for patients with De Winter syndrome. The subsequent clinical course was uneventful.

Key words: myocardial infarction, acute disease, coronary artery disease, syndrome, De Winter syndrome