Wellens Syndrome: A Rare ECG Finding in Subendocardial Myocardial Infarction
Creators
- 1. Department of General Medicine, People's College of Medical Sciences and Research Centre, Bhopal
Description
Wellen's Syndrome describes a pattern of electrocardiographic (ECG) changes, particularly deeply inverted or
biphasic T waves in leads V2-V3, which is specific for proximal stenosis of the left anterior descending (LAD) coronary
artery. It is also known as 'Anterior Descending T-Wave Syndrome' . These patients usually do not report any chest pain and
[1]
their cardiac enzymes are normal or only mildly elevated. Nevertheless, it is crucial to recognize ECG patterns as these
patients are at high risk for imminent large 'Anterior Wall Acute Myocardial Infarction'. We illustrate here in an
asymptomatic patient reporting in the emergency department with history of chest pain. He was identified as a case of
'Wellen's Syndrome' based on typical ECG findings.
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Additional details
References
- 1. Miner B, Hart EH. Wellens Syndrome. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019.
- 2. Hancock EW, Deal BJ, Mirvis DM, Okin P, Kligfield P, Gettes LS, et al. AHA/ACCF/HRS recommen- dations for the standardization and interpretation of the electrocardiogram: part V: electrocardiogram changes associated with cardiac chamber hypertrophy: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society . J Am Coll Cardiol 2009; 53(11): 992–1002.
- 3. de Zwaan C, Bar FW, Janssen JH, Cheriex EC, Dassen WR, Brugada P, et al. Angiographic and clinical characteristics of patients with unstable angina showing an ECG pattern indicating critical narrowing of the proximal LAD coronary artery. Am Heart J 1989; 117: 657–665.
- 4. Udechukwu N, Shrestha P, Khan MZ, Donato AA. Wellens' syndrome: a close call. BMJ Case Rep. 2018.
- 5. Ramires TG, Sant'Anna J, Pais J, Picarra BC. Wellens' syndrome: a pattern to remember. BMJ Case Rep. 2018;10:2018.