Chest Pain in the Deployed Setting: A Case of Wellens Syndrome

Managing patients with chest pain in deployed and austere environments can be extremely challenging for military health care providers. Limited resources, including access to equipment, emergent cardiac catheterization, and cardiac surgery, can lead to deleterious consequences, including myonecrosis and possible death. Wellens syndrome is a form of acute coronary syndrome that involves stenosis of the left anterior descending coronary artery, leading to possible acute myocardial infarction. Most cases in the literature involve the diagnosis and treatment of Wellens syndrome in the civilian, nondeployed hospital setting. We present a case of a civilian contractor who had experienced an episode of chest pain that had resolved with rest and now had new findings on electrocardiogram concerning Wellens syndrome.