Inayat Faisal, Riaz Iqra, Ali Nouman Safdar, Figueredo Vincent M
Allama Iqbal Medical College, Lahore, Pakistan.
Einstein Medical Center, Philadelphia, Pennsylvania, USA.
BMJ Case Rep. 2018 Jun 29;2018:bcr-2018-225755. doi: 10.1136/bcr-2018-225755.
Wellens' syndrome is an electrocardiographic pattern of T-wave changes associated with critical stenosis of the proximal left anterior descending artery, signifying imminent risk of an anterior-wall myocardial infarction. The Wellens' electrocardiographic pattern can also be noted in several cardiac and non-cardiac diseases. We chronicle here a unique case of a patient who presented with atypical left chest pain and dizziness for 6 hours. His pain started after he smoked phencyclidine-laced cannabis. Cardiac panel demonstrated normal troponin T levels. Electrocardiogram showed sinus rhythm with new deep biphasic T-wave inversions in anterolateral leads. Coronary angiography showed no pathological processes. Subsequently, ECG changes resolved coincidentally with the resolution of chest pain. He was eventually diagnosed with pseudo-Wellens' syndrome. This paper illustrates that physicians should be vigilant for Wellens' syndrome mimicked by acute phencyclidine and cannabis intoxication. Additionally, we present a review of various aetiologies of pseudo-Wellens' syndrome, especially in patients with substance abuse.
Wellens综合征是一种与左前降支近端严重狭窄相关的T波改变的心电图模式，预示着前壁心肌梗死的迫在眉睫的风险。Wellens心电图模式也可见于多种心脏和非心脏疾病。我们在此记录了一例独特的病例，该患者出现非典型左胸痛和头晕6小时。他在吸食掺有苯环己哌啶的大麻后开始疼痛。心脏检查显示肌钙蛋白T水平正常。心电图显示窦性心律，前外侧导联出现新的深双相T波倒置。冠状动脉造影未显示病理过程。随后，心电图改变与胸痛缓解同时消失。他最终被诊断为假性Wellens综合征。本文表明，医生应警惕急性苯环己哌啶和大麻中毒模拟的Wellens综合征。此外，我们对假性Wellens综合征的各种病因进行了综述，特别是在药物滥用患者中。
