Key result
Serial ECGs reveal progression to de Winter and Wellens patterns identifying critical proximal LAD stenosis.
Case Report (n=1)
Highlights the clinical presentation of a hypertensive emergency with angina-like chest pain and the importance of serial ECGs.
Supports serial ECG vigilance in persistent chest pain; leaves open prospective validation before practice change.
Chest pain: The importance of serial ECGsA 44-year-old man, previously well, pre- sented to the emergency department with severe hypertension and a 4-hour history of typical angina-like chest pain with associated diaphoresis.He had dyslipidemia, a 5-pack-year history of smoking, and, likely, undiagnosed hypertension.On arrival, his blood pressure was 200/110 mm Hg, representing a hypertensive emergency.A clinical examination was unremarkable.A blood sample was sent for troponin analysis, and a nitroglycerin infusion was started.
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Rensburg et al. (2021) conducted a case report in Acute coronary syndrome with de Winter and Wellens ECG patterns (n=1). Serial electrocardiography was evaluated. Serial ECGs in a patient with ongoing chest pain and an initially inconclusive ECG revealed progression to high-risk de Winter and Wellens patterns, leading to the diagnosis of critical proximal LAD stenosis.
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