Schears Markayle R, Sleigh Bryan C, Ganti Latha
Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA.
Emergency Medicine, Mercer University College of Medicine, Macon, USA.
Cureus. 2019 Apr 5;11(4):e4394. doi: 10.7759/cureus.4394.
The authors present a case of Wellen's syndrome, which has a characteristic T-wave on an electrocardiogram during a pain-free period in a patient with intermittent chest pain. The clinical presentation, pathophysiology, and management is discussed, and the importance of obtaining more than one electrocardiogram (ECG) is explained. What this case adds to the literature is the fact that Wellen's syndrome patients may present atypically with active chest pain and, as such, should be managed similarly to acute myocardial infarction patients. However, because the diagnosis of Wellen's syndrome depends on an ECG obtained during the ensuing pain-free period, serial ECGs are usually required to reveal T-wave abnormalities in this context and have been shown to be disposition-altering in the Emergency Department (ED). Support for the death-denying outcome preferred in Wellen's syndrome by patients and providers alike depends on recognizing the diagnosis and consulting cardiology expediently.
作者介绍了一例韦伦综合征病例，该病例在间歇性胸痛患者的无痛期心电图上有特征性T波。文中讨论了其临床表现、病理生理学和治疗方法，并解释了获取多份心电图（ECG）的重要性。该病例为文献增添的内容是，韦伦综合征患者可能以活动性胸痛的非典型表现出现，因此应与急性心肌梗死患者进行类似的处理。然而，由于韦伦综合征的诊断依赖于随后无痛期获得的心电图，在此情况下通常需要连续心电图来揭示T波异常，并且已证明其在急诊科（ED）可改变治疗决策。患者和医护人员对韦伦综合征中更倾向的否认死亡结局的支持取决于及时识别诊断并咨询心脏病专家。
