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Wellens' syndrome with segmental wall-motion abnormalities.

Turgay Celik1, Baris Bugan1, Serdar Firtina1

  • 1Gulhane Military Medical Academy, Department of Cardiology, Ankara, Turkey.

Open Access Emergency Medicine : OAEM
|May 6, 2016
PubMed
Summary
This summary is machine-generated.

Wellens' syndrome, characterized by specific ECG T-wave changes, indicates critical blockage in the left anterior descending artery. Prompt intervention with stenting resolved wall-motion abnormalities in two reported cases.

Keywords:
T-wave syndromeWellens’ syndromewall-motion abnormality

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Area of Science:

  • Cardiology
  • Diagnostic Electrocardiography
  • Interventional Cardiology

Background:

  • Wellens' syndrome is a specific electrocardiographic pattern linked to critical proximal left anterior descending (LAD) artery stenosis.
  • It is characterized by distinct T-wave abnormalities on the ECG.
  • This syndrome often presents with chest pain but normal or minimally elevated cardiac enzymes.

Observation:

  • Two cases of Wellens' syndrome with associated segmental wall-motion abnormalities are presented.
  • Case 1: A 50-year-old male with chest pain showed biphasic T waves (V1-V3) and inverted T waves (V4-V6) on ECG.
  • Case 2: A 62-year-old female with rest chest pain exhibited deeply inverted T waves (V1-V4) on ECG with minimal troponin T elevation.

Findings:

  • Both patients had critical stenotic lesions identified in the proximal LAD artery.
  • Successful percutaneous coronary intervention (PCI) with stent deployment was performed in both cases.
  • Post-intervention, the segmental wall-motion abnormalities observed in both patients resolved.

Implications:

  • Wellens' syndrome is a crucial indicator of significant LAD stenosis requiring urgent attention.
  • Prompt diagnosis and revascularization can effectively reverse myocardial dysfunction.
  • ECG findings suggestive of Wellens' syndrome warrant immediate cardiac evaluation and intervention to prevent adverse outcomes.