De Winter sign combined with pronounced aVR lead ST segment elevation and left anterior fascicular block: a case report

This case highlights the clinical significance of the de Winter sign with pronounced aVR ST segment elevation, which may suggest severe coronary artery disease. The resolution of LAFB post-PCI suggests reversibility of conduction abnormalities with improved perfusion. Early recognition and intervention are crucial for better outcomes. Clinicians should be vigilant about this rare ECG pattern.