Wellen's syndrome

Wellens' syndrome is a pattern of electrocardiographic (ECG) changes associated with critical stenosis of the proximal left anterior descending (LAD) coronary artery. It was first described by the Dutch cardiologist Hein J.J. Wellens in the 1980s.

Clinical Presentation[edit | edit source]

Patients with Wellens' syndrome typically present with a history of chest pain, which has often resolved by the time of presentation. The syndrome is often associated with a normal or minimally elevated Troponin level, and the ECG changes may be the only clue to the diagnosis.

ECG Findings[edit | edit source]

The characteristic ECG changes in Wellens' syndrome are biphasic or deeply inverted T-waves in the precordial leads (V2-V3), often with preservation of the R-wave progression. These changes are typically present during pain-free periods and may be transient, reverting to normal between episodes of chest pain.

Diagnosis[edit | edit source]

The diagnosis of Wellens' syndrome is based on the clinical history and ECG findings. It is important to recognize this syndrome as it is associated with a high risk of anterior wall myocardial infarction if not treated promptly.

Treatment[edit | edit source]

The treatment of Wellens' syndrome involves urgent coronary angiography and revascularization, typically by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).

Prognosis[edit | edit source]

The prognosis of Wellens' syndrome is poor if left untreated, with a high risk of anterior wall myocardial infarction and death. However, with prompt recognition and treatment, the prognosis can be significantly improved.

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Brown atrophy of the heart

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Keshan disease

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Loeffler endocarditis

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Nonbacterial thrombotic endocarditis

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