Troponin May Lie: Recognizing an Atypical Case of Wellens Syndrome
Juthipong Benjanuwattra1, Cristian Castillo-Rodriguez2, Manisha Das1
1Division of Cardiology University of Cincinnati Cincinnati Ohio USA.
Insights
Wellens syndrome indicates critical coronary artery blockage and imminent heart attack. Prompt recognition is vital for urgent revascularization, as delayed diagnosis or noninvasive tests can be harmful.
Area of Science:
- Cardiology
- Emergency Medicine
- Diagnostic Imaging
Background:
- Wellens syndrome is a critical clinical presentation associated with significant coronary artery stenosis.
- It often precedes an extensive myocardial infarction, posing a high risk to patients.
Purpose of the Study:
- To emphasize the importance of recognizing Wellens syndrome for timely intervention.
- To highlight the potential pitfalls in diagnosing this condition using standard methods.
Main Methods:
- Review of clinical cases and diagnostic criteria for Wellens syndrome.
- Analysis of the impact of delayed diagnosis and inappropriate testing on patient outcomes.
Main Results:
- Electrocardiogram (ECG) and troponin levels can be misleading in Wellens syndrome.
- Urgent revascularization is crucial for patients presenting with this syndrome.
Conclusions:
- Early identification of Wellens syndrome is paramount to prevent extensive myocardial infarction.
- Noninvasive stress tests and delayed recognition are detrimental and should be avoided.
Abstract:
Wellens syndrome is associated with a critical coronary artery stenosis and an impending extensive myocardial infarction. Despite having chest pain, both ECG and troponin can be misleading. It is crucial to recognize this syndrome to allow urgent revascularization. Failure to recognize and noninvasive stress tests were shown to be detrimental.
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