Key result
Medical therapy successfully controls pseudo-Wellens syndrome from mid-LAD myocardial bridging through 6 months.
Why the study?
Pseudo-Wellens syndrome mimics classical Wellens syndrome electrocardiographically but occurs without critical proximal LAD stenosis, with myocardial bridging as an important under-recognized cause.
Case Report (n=3)
Myocardial bridging is an important non-obstructive cause of pseudo-Wellens syndrome that can present without fixed coronary stenosis and can be successfully treated with medical management.
Consider myocardial bridging in Wellens-like ECGs without fixed stenosis; leaves open its prevalence and management implications.
Pseudo-Wellens syndrome describes electrocardiographic changes that resemble classical Wellens syndrome, with biphasic or deeply inverted T waves in anterior precordial leads, but without critical proximal left anterior descending (LAD) artery stenosis. Myocardial bridging is an important and often under-recognized non-obstructive cause, in which dynamic systolic compression of a tunneled LAD segment produces transient ischemia and Wellens-like T-wave abnormalities. We report a three-cases of pseudo-Wellens syndrome caused by mid-LAD myocardial bridging. Coronary angiography showed dynamic systolic compression without fixed obstructive coronary artery disease, and all three were successfully managed medically and remained asymptomatic at 6 months of follow-up.
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Gitte et al. (2026) conducted a case report in Pseudo-Wellens syndrome secondary to myocardial bridging (n=3). Mid-LAD myocardial bridging was evaluated on Symptom status. Three patients with pseudo-Wellens syndrome caused by mid-LAD myocardial bridging were successfully managed medically and remained asymptomatic at 6 months of follow-up.
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