Key result
A patient presenting with classic Wellens' syndrome ECG changes was found to have an atypical 95% stenosis in the mid-LAD, which was successfully treated with a drug-eluting stent.
Case Report (n=1)
No
This case highlights that Wellens' syndrome can atypically present with critical stenosis in the mid LAD rather than the proximal LAD.
Wellens' ECG pattern may reflect mid-LAD stenosis; single case leaves open broader anatomic correlations.
Wellens' syndrome is a pattern of electrocardiographic T-wave changes seen in the precordial leads in patients with unstable angina. Two different patterns have been described. Type A presents with biphasic T-waves in V2-V3 and type B presents with symmetrical deep T-wave inversions in V2-V3. The etiology is related to a critical stenosis in the proximal left anterior descending artery (LAD). We describe a patient who presented at our emergency department with intermittent chest pain and showing Wellens' pattern T-wave inversions in the precordial leads of the electrocardiogram. She was found to have 95% stenosis in mid LAD.
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Ghizzoni et al. (2019) conducted a case report in Wellens' syndrome (n=1). Percutaneous transluminal coronary angioplasty with drug-eluting stent was evaluated on Coronary revascularization. A patient presenting with classic Wellens' syndrome ECG changes was found to have an atypical 95% stenosis in the mid-LAD, which was successfully treated with a drug-eluting stent.
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