Wellens’ Syndrome,☆☆,

https://doi.org/10.1016/S0196-0644(99)70373-2Get rights and content

Abstract

We describe a patient with Wellens’ syndrome. In view of the large area of myocardium at risk, the importance of recognizing the significance of this ECG pattern is of critical importance for the emergency physician, especially those involved in the evaluation of patients at emergency department chest pain centers. Wellens’ syndrome, the criteria for diagnosis, and a discussion of its implications are presented. [Tandy TK, Bottomy DP, Lewis JG: Wellens’ syndrome. Ann Emerg Med March 1999;33:347-351.]

Section snippets

INTRODUCTION

In 1982, H. J. J. Wellens and his group first described a characteristic ECG pattern of T waves in the precordial leads that were associated with a critical stenosis of the proximal left anterior descending coronary artery.1 Recognition of this pattern, and appropriate intervention, prevents a potentially devastating anterior wall myocardial infarction. Importantly for the emergency physician, Wellens’ T-wave changes usually occur during a pain-free interval when other evidence of ischemia or

CASE REPORT

A 39-year-old white man presented to an outlying hospital with a complaint of intermittent, sharp, substernal chest pain of several weeks’ duration; the pain occurred at rest and with exercise. He had a history of hypertension and diabetes, smoked, had a positive family history for cardiac disease, and his cholesterol level was unknown. He had normal physical examination findings, blood electrolyte levels, ECG (unavailable for review), and cardiac enzyme determination done 2 weeks previously as

DISCUSSION

In 1982, Wellens and his colleagues first published the clinical and ECG criteria of a subgroup of patients with myocardial ischemia that later came to be known as Wellens’ syndrome.1 Recognition of this ECG pattern allowed the identification of patients who had a critical stenosis of the proximal left anterior descending coronary artery and hence were at risk for an extensive anterior wall myocardial infarction. In Wellens’ study, the ECG changes were not rare. Of the initial study group of

References (13)

There are more references available in the full text version of this article.

Cited by (84)

View all citing articles on Scopus

Assertions and opinions herein are the views of the authors and should not be construed as official or as reflecting the views of the Department of Defense or the Department of the Navy.

☆☆

Reprints not available from the authors.

47/1/96041

View full text