Elkholy Karim O, Mirashi Elidona, Malyshev Yury, Charles Gregory, Sahni Sonu
Internal Medicine, Brookdale University Hospital Medical Center, New York, USA.
Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA.
Cureus. 2021 Feb 11;13(2):e13290. doi: 10.7759/cureus.13290.
The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-Cov2), is the causative pathogen of coronavirus disease 2019 (COVID-19), which is primarily described as a respiratory illness. However, a wide array of cardiovascular complications has also been described in the setting of COVID-19. Wellens' syndrome, also regarded as a left anterior descending coronary T-wave syndrome, is an electrocardiography (EKG) pattern that indicates critical proximal left anterior descending (LAD) artery 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. To our knowledge, we present the first case of Wellens' syndrome in a patient with a COVID-19 infection. Furthermore, this case describes stenosis of the left circumflex artery, a variant of the unusual angiographic findings associated with Wellens', as it is usually associated with occlusion of the proximal LAD. The pathophysiology of cardiovascular complications associated with COVID-19 is not well-understood; nevertheless, it was reported that mortality from coronary artery disease (CAD) complications is significantly higher in these patient populations. Healthcare providers should also be aware of identifying Wellens' syndrome, as urgent coronary angiography is superior to stress testing.
新型冠状病毒，即严重急性呼吸综合征冠状病毒2（SARS-CoV-2），是2019冠状病毒病（COVID-19）的致病病原体，该病主要表现为呼吸系统疾病。然而，在COVID-19患者中也发现了一系列心血管并发症。Wellens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（LAD）近端严重狭窄。其特征是不稳定型心绞痛患者胸前导联出现深倒置T波或双向T波。患者通常表现出与急性冠状动脉综合征一致的症状。据我们所知，我们报告了首例COVID-19感染患者出现Wellens综合征的病例。此外，该病例描述了左旋支动脉狭窄，这是与Wellens综合征相关的不寻常血管造影结果的一种变体，因为它通常与LAD近端闭塞有关。与COVID-19相关的心血管并发症的病理生理学尚不完全清楚；然而，据报道，这些患者群体中冠状动脉疾病（CAD）并发症的死亡率显著更高。医疗保健提供者也应意识到识别Wellens综合征，因为紧急冠状动脉造影优于负荷试验。
