Ajibawo Temitope, Andreev Alexander, Sahni Sonu
Internal Medicine, Brookdale University Hospital Medical Center, New York, USA.
Cureus. 2020 Feb 4;12(2):e6877. doi: 10.7759/cureus.6877.
Wellens' syndrome, also regarded as left anterior descending coronary T-wave syndrome, is an electrocardiography (EKG) pattern that indicates critical proximal left anterior descending artery (LAD) stenosis. It is characterized by deeply inverted T-waves or biphasic T-waves in the anterior precordial chest leads in a patient with unstable angina. Patients typically present with symptoms consistent with acute coronary syndrome. We present a unique case of Wellens' syndrome with no angiographic findings of significant stenosis in the proximal LAD but with significant occlusion of the proximal circumflex artery and initial presentation with a chief complaint of epigastric pain and syncope. Physicians need to recognize these characteristic EKG changes during the pre-infarction stage, as they represent myocardial necrosis. Many of these patients eventually develop extensive anterior myocardial infarction with marked left ventricular dysfunction and death if coronary angiography and coronary revascularization are not performed within a few weeks. If Wellens' is seen, patients should undergo urgent cardiac catheterization.
韦伦斯综合征，也被视为左前降支冠状动脉T波综合征，是一种心电图（EKG）模式，提示左前降支近端严重狭窄。其特征是不稳定型心绞痛患者胸前导联T波深倒置或双向T波。患者通常表现出与急性冠状动脉综合征相符的症状。我们报告了一例独特的韦伦斯综合征病例，其左前降支近端无明显狭窄的血管造影表现，但回旋支近端严重闭塞，最初的主诉是上腹部疼痛和晕厥。医生需要在梗死前期识别这些特征性的心电图变化，因为它们代表心肌坏死。如果在几周内不进行冠状动脉造影和冠状动脉血运重建，许多此类患者最终会发展为广泛的前壁心肌梗死，伴有明显的左心室功能障碍甚至死亡。如果发现韦伦斯综合征，患者应接受紧急心脏导管插入术。
