A Wellens syndrome ECG pattern can occasionally present in patients with multi-vessel coronary artery disease rather than isolated critical proximal LAD stenosis.
May indicate multi-vessel CAD without proximal LAD stenosis; extends classic associations but remains hypothesis-generating.
Wellens syndrome is an electrocardiogram (ECG) pattern associated with critical stenosis of the proximal left anterior descending (LAD) artery. In patients with Wellens syndrome, characteristic biphasic or inverted T waves are seen on ECG. This case report presents a 48-year-old male admitted for chest pain and shortness of breath who was found to have a Wellens syndrome ECG pattern. Oddly, cardiac catheterization revealed multi-vessel coronary artery disease, and critical proximal LAD artery stenosis was not appreciated. Ultimately, the patient was treated with coronary artery bypass graft (CABG) surgery and later discharged in stable condition.
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Parekh et al. (2022) studied this question.
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