Why the study?
Wellen's syndrome typically indicates proximal LAD stenosis, and left main coronary artery lesions presenting with Wellen's ECG patterns have rarely been reported.
Case Report (n=1)
Wellen's syndrome type B ECG pattern can be caused by severe ostial stenosis of the left main coronary artery, requiring prompt recognition and emergent reperfusion therapy.
Suggests LMCA ostial stenosis as a Wellens type B cause needing prompt intervention; single case leaves broader applicability open.
BACKGROUND: Wellen's syndrome may indicate severe stenosis or even occlusion of the proximal left anterior descending coronary artery. It may progress to acute myocardial infarction. Early recognition and an early invasive strategy are critical to avoiding impending myocardial injury. To our knowledge, only one case of Wellen's electrocardiogram patterns caused by left main coronary artery (LM) lesions has been reported. CASE PRESENTATION: A 61-year-old man with a history of hypertension and smoking presented to the emergency department complaining of paroxysmal chest pain for the preceding 6 days. In the present case, the T-wave symmetric inversions in the V2 and V3 leads is associated with severe ostial stenosis of LM, which appears similar to Wellen's type B pattern. CONCLUSIONS: Practitioners should familiarize themselves with such uncommon LM lesions patterns and perform emergent reperfusion therapy.
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Tan et al. (2024) conducted a case report in Wellen's syndrome (n=1). Percutaneous coronary intervention was evaluated on Resolution of symptoms and ECG changes.
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