Wellens’ Syndrome☆,☆☆,★
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)
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Anatomic and prognostic significance of new T-wave inversion in unstable angina
Am J Cardiol
(1983) - et al.
Safety of immediate treadmill testing in selected emergency department patients with chest pain
Am J Emerg Med
(1991) - et al.
Outcome of patients who were admitted to a new short stay unit to “rule-out” myocardial infarction
Am J Cardiol
(1991) Bär FW, Wellens HJJ: Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction
Am Heart J
(1982)- et al.
Acute ischemic coronary syndromes
- et al.
Electrocardiography in the patient with myocardial ischemia or infarction
Cited by (84)
Wellens syndrome progressing from a very subtle type A to a classic type B Wellens pattern
2023, Cardiovascular Revascularization MedicineWellens Syndrome or Inverted U Waves: A Serious Clinical Condition Needing Immediate Attention Regardless of Symptoms
2021, American Journal of MedicinePrevalence and association of the Wellens' sign with coronary artery disease in an ethnically diverse urban population
2020, Journal of ElectrocardiologyWellens Syndrome: prevalence, risk factors and coronary angiographic variation. A cross-sectional study
2024, BMC Cardiovascular Disorders
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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.
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Reprints not available from the authors.
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