Key result
Atypical Wellens' syndrome manifests with ~65% mid-LAD stenosis rather than classic proximal occlusion.
Why the study?
Wellens’ syndrome is classically associated with critical proximal LAD stenosis, but atypical presentations and lesion locations are not well characterized.
Case Report (n=1)
No
Atypical asymptomatic Wellens' pattern may signal mid-LAD stenosis; extends classic criteria but leaves open need for validation.
Wellens’ syndrome is a phenomenon of T-wave inversions seen in the precordial leads of the electrocardiogram in the patients with unstable angina. This finding is seen in the pain-free state. 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. This etiology signifies critical stenosis in proximal left anterior descending artery (LAD). We describe a patient who was admitted for an elective surgery without a history of chest pain noted to have Wellens pattern T-wave inversions on telemetry and found to have 60-70% stenosis in mid LAD. J Med Cases. 2018;9(6):173-176 doi: https://doi.org/10.14740/jmc3058e
No takes yet. Share an insight, caveat, or question.
Mufti et al. (2018) conducted a case report in Wellens' syndrome (n=1). Atypical Wellens' syndrome presentation was evaluated on Location of coronary artery stenosis. An asymptomatic 87-year-old woman with atypical Wellens' syndrome EKG changes was found to have 60-70% stenosis in the mid-LAD rather than the classical proximal LAD.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: