For physicians: Never forget the specific ECG T-wave changes of Wellens' syndrome

Liu, Mao; Chen, Jian; Wu, Wei; Liu, Tianmin; Liu, Changzhi; Huang, Dan

doi:10.1016/j.ijcard.2013.01.069

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…Wellens syndrome, a specific ECG manifestation in high-risk patients with unstable angina pectoris, has an incidence of 0.1%[ 7 ] and a prevalence of 14%-18%[ 8 ] in patients with unstable angina pectoris. A history of angina, inverted or biphasic T-waves in the precordial ECG leads during the pain-free period, and little or no abnormality in cardiac biomarkers are key diagnostic indicators[ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Entire process of electrocardiogram recording of Wellens syndrome: A case report

Tang¹,

Li²,

Liang³

et al. 2022

WJCC

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BACKGROUND Wellens syndrome is an electrocardiogram (ECG) pattern seen in high-risk patients with unstable angina pectoris. It is characterized by inverted or biphasic T-waves that change into positive or pseudo-normalized waves at precordial leads when the patient experiences an angina attack; however, the mechanism for this condition remains unclear. CASE SUMMARY A 47-year-old male patient experienced repeated, unprovoked episodes of chest pain for > 20 d, with worsening during the previous day. On the day of admission, he experienced episodes of paroxysmal chest pain lasting more than 30 min, in addition to radiating pain to the left arm and exertional dyspnea. The patient presented to the emergency department with no chest pain or other discomfort at that time. ECG at presentation showed sinus tachycardia and T-wave changes, which were identified as Wellens syndrome when combined with previous ECG findings. ECGs and myocardial enzymology examinations were normal when angina was present, but the ECG showed inverted or biphasic T-waves when angina was absent. After percutaneous coronary intervention, the ECGs demonstrated inverted or biphasic T-waves in the anterior precordial leads on days 0, 1, and 2, but normal T-waves on day 3. The ECGs showed no subsequent ischemic ST-T-wave changes. CONCLUSION The Wellens syndrome pseudo-normalized T-waves likely reflect development of unstable angina pectoris into the hyperacute phase of ST-segment elevation myocardial infarction.

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Section: Discussionmentioning

confidence: 99%

Entire process of electrocardiogram recording of Wellens syndrome: A case report

Tang¹,

Li²,

Liang³

et al. 2022

WJCC

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show abstract

“…Biphasic T waves are called Type A like in our second presented ECG approximately 25% of cases and the deeply symmetrical inverted T waves are called Type B like in our first presented ECG approximately 75% of cases. [4][5][6] It is important to recognize the elec- trocardiogram characteristics of Wellens' syndrome in order to provide early invasive treatment before myocardial infarction develops. Although most physicians recognize STEMI in an ECG but other clinical situations such as Wellens' syndrome are not well known.…”

Section: Discussionmentioning

confidence: 99%

“…5 The biphasic T waves are often commented as nonspecific repolarization changes and oc-casionally ignored, which can be mortal. [6][7][8] ECG changes with inverted T waves can develope in different clinical situations including myocardial infarction in the past, persistent juvenile T wave pattern, bundle branch block, left ventricular hypertrophy, acute myocarditis, pre-excitation syndromes, acute pulmonary embolism, pericarditis, cerebrovascular event, and digitalis effect. 6 Without rapid diagnosis and treatment, patients with Wellens' syndrome can develop extensive anterior STEMI, with a mean time of 8.5 days.…”

Section: Discussionmentioning

confidence: 99%

Troponin is Not Everything, a Difficult Diagnosis That Should be Kept in Mind: Wellens' Syndrome

Keskin¹,

Demır²

2020

Turkiye Klinikleri J Case Rep

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ABS TRACT Chest pain is one of the most common problems evaluated in the emergency department (ED). In addition to physical examination, electrocardiography (ECG) and cardiac biomarkers are often used in the initial assessment of patient in ED. Wellens' syndrome is characterized by electrocardiographic T-wave changes especially in leads V2-V3 with severe proximal stenosis of the left anterior descending artery (LAD). We report a Wellens' syndrome case which acute anterior myocardial infarction developed after 7 hours later since after the first emergency contact. It is important to rapidly and accurately risk-stratify patients with suspected acute coronary syndrome. Especially emergency physicians must be aware of negative T wave in leads V2-V3 on ECG and must know that only one normal troponin value alone does not exclude the diagnosis of acute coronary syndrome. It is very important to recognize Wellens' syndrome early, as it allows rapid invasive intervention for cardiologist and cardiovascular surgery, so that extensive myocardial infarction can be prevented and perhaps a life can be saved.

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“…En el estudio que lo describió 6 , 26 de 145 pacientes admitidos con angina (18%) tenían cambios electrocardiográficos compatibles con síndrome de Wellens, el 75% que no fueron revascularizados desarrollaron un infarto anterior extenso en los siguientes 23 días con una media de 8,5 días 10,11,14 . En un estudio posterior se encontró que 160 de 1.260 pacientes hospitalizados tenían el característico patrón electrocardiográfico de síndrome de Wellens y en todos se encontró enfermedad de la descendente anterior proximal 8 .…”

Section: Discussionunclassified

Síndrome de Wellens: reconociendo el peligro

Carvajal¹,

Ardila²

2015

Revista Colombiana de Cardiología

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For physicians: Never forget the specific ECG T-wave changes of Wellens' syndrome

Cited by 6 publications

References 6 publications

Entire process of electrocardiogram recording of Wellens syndrome: A case report

Entire process of electrocardiogram recording of Wellens syndrome: A case report

Troponin is Not Everything, a Difficult Diagnosis That Should be Kept in Mind: Wellens' Syndrome

Síndrome de Wellens: reconociendo el peligro

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