Wellens syndrome is a unique electrocardiographic (ECG) pattern usually suggestive of critical stenosis of the left anterior descending (LAD) coronary artery. Providers must recognize this pattern as it frequently occurs in symptom-free periods and represents a pre-infarction stage requiring early intervention. We present the case of a 39-year-old male with a past medical history of hypertension who was brought to the emergency department due to complaints of worsening recurrent intermittent squeezing left-sided chest pain of two months duration. Cardiac enzymes were within limits. ECG done at triage was significant for biphasic T waves in leads V2-V5 consistent with type A Wellens syndrome. The cardiology team consulted, with the patient subsequently having a percutaneous coronary intervention to the mid and proximal portion of the LAD. The patient was later discharged on the third day of admission on guideline-directed medical therapy, with plans to follow up closely with the cardiology clinic. This case highlights the significance of using the characteristics pattern of Wellens syndrome in providing critical diagnostic and prognostic value. This article aimed to promote awareness of Wellens syndrome, the clinical correlation, and the role of timely acute management.
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http://dx.doi.org/10.7759/cureus.36820 | DOI Listing |
Front Cardiovasc Med
January 2025
Cardiology Department and Experimental Animal Center, Liaocheng People's Hospital of Shandong University and Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng, Shandong, China.
Both de Winter syndrome and Wellens syndrome mainly indicate severe stenosis in the proximal segment of the anterior descending coronary artery. However, as research deepens, the accuracy and specificity of diagnosing proximal left anterior descending coronary artery (LAD) culprit lesions separately by de Winter syndrome or Wellens syndrome are challenged. The patient in this case developed both syndromes in a short period of time, and imaging showed significant stenosis of the proximal LAD, indicating a culprit lesion.
View Article and Find Full Text PDFCureus
November 2024
Cardiology, Kasturba Medical College, Manipal, Manipal, IND.
SAGE Open Med Case Rep
December 2024
Cardiology A Department, Ibn Sina University Hospital Center, Rabat, Morocco.
Traditionally reflecting critical stenosis of the proximal left anterior descending (LAD) artery, Wellens' syndrome (WS) is an electrocardiogram (ECG) pattern of biphasic or deeply inverted T waves in leads V2 and V3. This critical stenosis can progress to an extensive anterior myocardial infarction (MI) if early and appropriate management is not received promptly. The diagnosis of severe stenosis of the LAD coronary artery can be made by using electrocardiographic changes in Wellens' syndrome.
View Article and Find Full Text PDFBMC Cardiovasc Disord
November 2024
Department of Cardiology, People's Hospital Affiliated to Chongqing Three Gorges Medical College, Chongqing, China.
Background: Wellen's syndrome may indicate severe stenosis or even occlusion of the proximal left anterior descending coronary artery. It may progress to acute myocardial infarction. Early recognition and an early invasive strategy are critical to avoiding impending myocardial injury.
View Article and Find Full Text PDFGut
January 2025
Gastroenterology and Hepatology, KU Leuven University Hospitals Leuven Gasthuisberg Campus Hospital Pharmacy, Leuven, Belgium
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