User:Mr. Ibrahem/Wellens' syndrome
| Wellens' syndrome | |
|---|---|
| Other names | Wellens syndrome, Wellens' sign, Wellens' warning, Wellens' waves, anterior descending T-wave syndrome |
 | |
| ECG of Wellens' syndrome. Note biphasic T-waves in leads V1-V4. | |
| Specialty | Cardiology |
| Symptoms | Angina that resolves[1] |
| Complications | Myocardial infarction[1] |
| Types | Type A, B[1] |
| Causes | Atherosclerosis, coronary vasospasm, Takotsubo cardiomyopathy[1] |
| Diagnostic method | ECG (deeply inverted or biphasic T waves in leads V2 and V3)[1] |
| Differential diagnosis | Brain injury, left ventricular hypertrophy (LVH), right bundle branch block (RBBB), hypertrophic cardiomyopathy (HOCM), pulmonary embolism, Brugada syndrome[1][2] |
| Treatment | Percutaneous coronary intervention (PCI)[1] |
| Medication | Aspirin, heparin[1] |
| Frequency | Relatively common[1] |
Wellens' syndrome is an electrocardiogram (ECG) pattern which often represents critical narrowing of the left anterior descending (LAD) coronary artery.[1] People often have chest pain, which resolves by the time they arrive at the hospital.[1] Complications include a 75% risk of myocardial infarction (MI) within weeks without appropriate treatment.[1]
The underlying mechanism is believed to involve rupture of an atherosclerotic plaque leading to blockage of the LAD, followed by clot breakdown before a MI occurs.[1] In about 90% of cases there is near blockage of the proximal LAD.[3] It can also occur in coronary vasospasm and Takotsubo cardiomyopathy.[1]
Diagnosis is based on an ECG showing deeply inverted or biphasic T waves in at least leads V2 and V3.[1][3] Other findings may include ST-segment elevation of less than 1 mm, no Q waves, and normal or slightly increased troponin.[1][3] When chest pain occurs, the ECG may appear normal.[1]
Treatment is by percutaneous coronary intervention (PCI).[1] Until this can be carried out, aspirin and heparin is typically used.[1] Wellens' syndrome is relatively common.[1] It was first described in 1982 by Hein Wellens.[4][5]
References[edit]
- ^ a b c d e f g h i j k l m n o p q r s t Miner, B; Grigg, WS; Hart, EH (January 2022). "Wellens Syndrome". PMID 29494097.
{{cite journal}}: Cite journal requires|journal=(help) - ^ Cadogan, Mike; Buttner, Robert; Buttner, Mike Cadogan and Robert (1 August 2020). "Wellens Syndrome". Life in the Fast Lane • LITFL. Archived from the original on 1 August 2021. Retrieved 28 July 2022.
- ^ a b c Tzimas, Georgios; Antiochos, Panagiotis; Monney, Pierre; Eeckhout, Eric; Meier, David; Fournier, Stephane; Harbaoui, Brahim; Muller, Olivier; Schläpfer, Jürg (October 2019). "Atypical Electrocardiographic Presentations in Need of Primary Percutaneous Coronary Intervention". The American Journal of Cardiology. 124 (8): 1305–1314. doi:10.1016/j.amjcard.2019.07.027.
- ^ PA-C, David Roberts, MSPAS, RN (31 December 2019). Mastering the 12-Lead EKG. Springer Publishing Company. p. 407. ISBN 978-0-8261-8194-7. Archived from the original on 28 July 2022. Retrieved 28 July 2022.
{{cite book}}: CS1 maint: multiple names: authors list (link) - ^ de Zwaan, C; Bär FW; Wellens HJJ (April 1982). "Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction". American Heart Journal. 103 (4): 730–736. doi:10.1016/0002-8703(82)90480-X. PMID 6121481.