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Wellens' syndrome
Pathology:
- severe stenosis of the left anterior descending artery
Clinical manifestations:
- recent history of angina pectoris
Laboratory:
- markers of myocardial infarction
- troponin-I in serum slightly elevated
Special laboratory:
- electrocardiogram
- deeply inverted T-waves or biphasic T waves in ECG lead V2- ECG lead V3 [1,2]
- isoelectric or minimally-elevated ST segment (< 1mm)
- no precordial Q waves
- preserved precordial R wave progression
- coronary angiography
- severe stenosis of the left anterior descending artery
Complications:
- anterior wall myocardial infarction
Management:
- drug-eluting coronary stent
- patients do poorly with medical therapy [2]
General
syndrome
coronary artery disease; coronary atherosclerosis (CAD)
References
- Kannan L Figueredo VM
Wellens' Syndrome
N Engl J Med 2015; 372:66. January 1, 2015
PMID: 25551527
http://www.nejm.org/doi/full/10.1056/NEJMicm1400946
- Life in the Fast Lane. ECG Library
Wellens' Syndrome
http://lifeinthefastlane.com/ecg-library/wellens-syndrome/
- Rhinehardt J, Brady WJ, Perron AD, Mattu A.
Electrocardiographic manifestations of Wellens' syndrome.
Am J Emerg Med. 2002 Nov;20(7):638-43
PMID: 12442245