NDLI: Omnious T-wave inversions: Wellens’ syndrome revisited

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Omnious T-wave inversions: Wellens’ syndrome revisited

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Omnious T-wave inversions: Wellens’ syndrome revisited

Content Provider	Taylor & Francis Online
Author	Kodali, Archana Aung, Thein Tun May, Cho Snyder, Richard Khalighi, Koroush Oo, Swe Zin Mar Win Htut
Abstract	Wellens’ syndrome is characterized by T-wave changes in electrocardiogram (EKG) during pain-free period in a patient with intermittent angina chest pain. It carries significant diagnostic and prognostic value because this syndrome represents a pre-infarction stage of coronary artery disease involving proximal left anterior descending (LAD) artery, which can subsequently lead to extensive anterior myocardial infarctions (MIs) and even death without coronary angioplasty. Therefore, it is crucial for every physician to recognize EKG features of Wellens’ syndrome in order to take appropriate immediate intervention to reduce mortality and morbidity for MI. Here, we report a case of an overweight man with 35 pack-year of smoking history who presented to Easton Hospital with intermittent pressing chest pain of 5/6 times within 10 day-period and was found to have type A Wellens’ sign, which was biphasic T-waves in precordial leads V2 and V3 during pain-free period with no cardiac enzymes elevation. He was given therapeutic lovenox and subsequently underwent coronary angioplasty and had 95–99% occlusion in proximal LAD artery. The unique feature of our case was that Wellens’ type B EKG changes were seen after reduction of stenosis with LAD artery stent, which was likely explained by the reperfusion of the ischemic myocardium. Therefore, it is important for physicians to recognize EKG features of Wellens’ syndrome in order to take appropriate therapy to reducing mortality and morbidity form impending MI.
File Format	PDF HTM / HTML
ISSN	20009666
DOI	10.3402/jchimp.v6.32011
Journal	Journal of Community Hospital Internal Medicine Perspectives
Volume Number	6
Issue Number	4
Language	English
Publisher	Taylor & Francis
Publisher Date	2016-09-07
Access Restriction	Open
Subject Keyword	T-inversion Wellens' syndrome Myocardial infarction Left anterior descending artery obstruction Electrocardiographic changes Revascularization
Content Type	Text
Subject	Internal Medicine

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