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Want to read an EKG like a 3rd year med student? Recognize ST elevations. Want to blow your attending away with your savant-like EKG mastery? Start learning all the myriad STEMI equivalents. For today: the de Winter’s T-wave.

What is it? Up-sweeping ST-depression and symmetrical peaked t-wave in pre-cordial leads (see below)

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What does it mean? Anterior STEMI-equivalent, can signify acute LAD occlusion. Often presents without concurrent ST elevations

How often will you see it? Not that often, but not to be missed. Per 2008 case report, appears in 2% of acute LAD occlusions

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