• Am J Emerg Med · Nov 2002

    Case Reports

    Electrocardiographic manifestations of Wellens' syndrome.

    • Joseph Rhinehardt, William J Brady, Andrew D Perron, and Amal Mattu.
    • Department of Emergency Medicine, University of Virginia, Charlottesville, VA 22908, USA.
    • Am J Emerg Med. 2002 Nov 1;20(7):638-43.

    AbstractWellens' syndrome is a pattern of electrocardiographic T-wave changes associated with critical, proximal left anterior descending (LAD) artery stenosis. The syndrome is also referred to as LAD coronary T-wave syndrome. Syndrome criteria include T-wave changes plus a history of anginal chest pain without serum marker abnormalities; patients lack Q waves and significant ST-segment elevation; such patients show normal precordial R-wave progression. The natural history of Wellens' syndrome is anterior wall acute myocardial infarction. The T-wave abnormalities are persistent and may remain in place for hours to weeks; the clinician likely will encounter these changes in the sensation-free patient. With definitive management of the stenosis, the changes resolve with normalization of the electrocardiogram. It is vital that the physician recognize these changes and the association with critical LAD obstruction and significant risk for anterior wall myocardial infarction.Copyright 2002, Elsevier Science (USA). All rights reserved.)

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