Wellens Syndrome Corollaries: A Call for Definition with a Case Series

First described in 1982, the Wellens wave is an electrocardiographic (ECG) finding indicative of a critical lesion of the left anterior descending artery. These T-wave findings are classically found in ECG leads V2 and V3, although they may extend into the lateral leads V4-V6.

We present three cases of patients with Wellens waves that were found only in leads V3 and V4 and did not include V2.

We suggest that the classical definition of T-waves in leads V2 and V3 is not the only manifestation of Wellens waves to indicate pathology. Wellens waves found in two contiguous leads in leads V1-V6 can be considered Wellens corollaries, thereby requiring the same emergent treatment as classical Wellens syndrome. We also recognize the need for a consensus on the inclusion criteria of Wellens syndrome, particularly the laboratory and ECG findings that define the disease.