Key result
Myocardial bridging can produce a pseudo-Wellens ECG pattern mimicking critical LAD stenosis via dynamic systolic compression.
Why the study?
Wellens syndrome is classically associated with critical proximal LAD stenosis, but nonatherosclerotic conditions such as myocardial bridging may mimic this pattern.
Case Report (n=1)
Myocardial bridging can mimic the Wellens syndrome ECG pattern, highlighting the need to recognize this nonatherosclerotic phenocopy to avoid unnecessary interventions.
May prompt bridging evaluation in pseudo-Wellens cases; leaves open prospective validation of ischemic risk.
BACKGROUND: Wellens syndrome is a preinfarction electrocardiographic pattern classically associated with critical proximal left anterior descending artery stenosis. However, nonatherosclerotic conditions, including myocardial bridging, may mimic this pattern. CASE SUMMARY: A 58-year-old man presented with intermittent chest pain and Wellens T-wave changes in the anterior leads. High-sensitivity troponin T levels were normal. Coronary angiography revealed normal coronary arteries with a mid left anterior descending myocardial bridge and no fixed stenosis. Beta-blocker therapy was deferred owing to baseline bradycardia. DISCUSSION: Myocardial bridging may produce a pseudo-Wellens pattern through dynamic systolic compression and transient ischemia. TAKE-HOME MESSAGE: Recognition of this phenocopy is essential to avoid misdiagnosis and unnecessary intervention.
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Zhou et al. (2026) conducted a case report in Pseudo-Wellens Syndrome (n=1). Myocardial bridging was evaluated. Myocardial bridging can produce a pseudo-Wellens electrocardiographic pattern through dynamic systolic compression and transient ischemia, mimicking critical left anterior descending artery stenosis.
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