Comparison
de Winter Pattern (OMI Equivalent) vs Classic STEMI (Transmural): clinical and ECG differences
Side-by-side comparison of de Winter Pattern (OMI Equivalent) and Classic STEMI (Transmural) according to the MioAtlas 3D cardiac simulator model.
de Winter Pattern (OMI Equivalent)
Classic STEMI (Transmural)
Findings by layer and diagnostic parameters
| Layer / Finding | de Winter Pattern (OMI Equivalent) | Classic STEMI (Transmural) |
|---|---|---|
| Clinical summary |
J-point depression of 1 to 3 mm with upsloping continuation into tall, peaked, symmetrical hyperacute T-waves in precordial leads (V1-V6), alongside ST elevation in aVR (0.5 to 1 mm). Critical subtotal occlusion of proximal LAD. |
Classic transmural epicardial injury pattern with upward convex ST-segment elevation and reciprocal changes in opposite leads. |
Sources and bibliographic references
de Winter Pattern (OMI Equivalent)
- Wagner GS, Macfarlane P, Wellens H, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: Part VI: Acute ischemia/infarction . Circulation (2009) . DOI: 10.1161/CIRCULATIONAHA.108.191098
- Thygesen K, Alpert JS, Jaffe AS, et al. Fourth Universal Definition of Myocardial Infarction (2018) . Eur Heart J (2019) . DOI: 10.1093/eurheartj/ehy462
- Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes . Circulation (2025) . DOI: 10.1161/CIR.0000000000001309 PubMed: 40014670
Classic STEMI (Transmural)
- Wagner GS, Macfarlane P, Wellens H, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: Part VI: Acute ischemia/infarction . Circulation (2009) . DOI: 10.1161/CIRCULATIONAHA.108.191098
- Thygesen K, Alpert JS, Jaffe AS, et al. Fourth Universal Definition of Myocardial Infarction (2018) . Eur Heart J (2019) . DOI: 10.1093/eurheartj/ehy462
- Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes . Circulation (2025) . DOI: 10.1161/CIR.0000000000001309 PubMed: 40014670