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Omnious T-wave inversions: Wellens' syndrome revisited
Journal article   Open access   Peer reviewed

Omnious T-wave inversions: Wellens' syndrome revisited

Swe Zin Mar Win Htut Oo, Koroush Khalighi, Archana Kodali, Cho May, Thein Tun Aung and Richard Snyder
Journal of community hospital internal medicine perspectives, v 6(4), 32011
01 Jan 2016
DOI: https://doi.org/10.3402/jchimp.v6.32011
PMID: 27609724
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.3402/jchimp.v6.32011View
Published, Version of Record (VoR)CC BY-NC V4.0,  Open

Abstract

electrocardiographic changes left anterior descending artery obstruction myocardial infarction revascularization T-inversion Wellens' syndrome
Wellens' syndrome is characterized by T-wave changes in electrocardiogram (EKG) during pain-free period in a patient with intermittent angina chest pain. It carries significant diagnostic and prognostic value because this syndrome represents a pre-infarction stage of coronary artery disease involving proximal left anterior descending (LAD) artery, which can subsequently lead to extensive anterior myocardial infarctions (MIs) and even death without coronary angioplasty. Therefore, it is crucial for every physician to recognize EKG features of Wellens' syndrome in order to take appropriate immediate intervention to reduce mortality and morbidity for MI. Here, we report a case of an overweight man with 35 pack-year of smoking history who presented to Easton Hospital with intermittent pressing chest pain of 5/6 times within 10 day-period and was found to have type A Wellens' sign, which was biphasic T-waves in precordial leads V2 and V3 during pain-free period with no cardiac enzymes elevation. He was given therapeutic lovenox and subsequently underwent coronary angioplasty and had 95-99% occlusion in proximal LAD artery. The unique feature of our case was that Wellens' type B EKG changes were seen after reduction of stenosis with LAD artery stent, which was likely explained by the reperfusion of the ischemic myocardium. Therefore, it is important for physicians to recognize EKG features of Wellens' syndrome in order to take appropriate therapy to reducing mortality and morbidity form impending MI.

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18 citations in Web of Science

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
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