Kandah Fadi, Mikulic Sebastian, Patel Pujan, Dhruva Pooja
Medicine, University of Florida Health-Jacksonville, Jacksonville, USA.
Cardiology, University of Florida Health-Jacksonville, Jacksonville, USA.
Cureus. 2020 Sep 11;12(9):e10390. doi: 10.7759/cureus.10390.
Wellen's syndrome is a pattern on ECG that signifies impending acute myocardial infarction (MI) of the proximal left anterior descending (LAD) artery. This same pattern can also be noted in several benign diseases that may mimic Wellen's syndrome. Here we discuss a 36-year-old patient with no cardiac risk factors who presented with typical angina shortly after smoking marijuana. Upon arrival to the ED, an electrocardiogram revealed new biphasic T wave inversions in the anterolateral leads and cardiac biomarkers were found to be elevated. The patient was taken for emergent coronary angiography which revealed widely patent coronary arteries. Soon after, the patient was diagnosed with Pseudo-Wellen's syndrome secondary to cannabis use. This case report highlights the importance of identifying causes that may resemble Wellen's syndrome, especially in young adults without risk factors for acute coronary syndrome (ACS). Recognizing these cases can help avoid further invasive diagnostic testing, along with the complications that may go along with it.
韦伦综合征是心电图上的一种表现模式,预示着左前降支(LAD)近端即将发生急性心肌梗死(MI)。在一些可能模仿韦伦综合征的良性疾病中也可观察到相同的模式。在此,我们讨论一名36岁无心脏危险因素的患者,该患者在吸食大麻后不久出现典型心绞痛。到达急诊科后,心电图显示前外侧导联出现新的双相T波倒置,且发现心脏生物标志物升高。患者接受了急诊冠状动脉造影,结果显示冠状动脉广泛通畅。此后不久,该患者被诊断为继发于大麻使用的假性韦伦综合征。本病例报告强调了识别可能类似韦伦综合征病因的重要性,尤其是在没有急性冠状动脉综合征(ACS)危险因素的年轻成年人中。识别这些病例有助于避免进一步的侵入性诊断检查及其可能伴随的并发症。