Nagdev Govind, Chavan Gajanan, Aurangabadkar Gaurang M
Emergency Medicine, Jawaharlal Nehru Medical College, Wardha, IND.
Respiratory Medicine, Jawaharlal Nehru Medical College, Wardha, IND.
Cureus. 2022 May 20;14(5):e25158. doi: 10.7759/cureus.25158. eCollection 2022 May.
Wellen's syndrome is associated with critical stenosis of the left anterior descending coronary artery. Based on the electrocardiography (ECG) pattern, Wellen's syndrome can be classified into type 1 (deeply inverted T-waves, mainly in lead V2 and V3) or type 2 (biphasic T-waves). T-wave abnormalities are often also found in V1 and V4 and rarely in V5 and V6. The pattern of ECG changes correlates with proximal left anterior descending artery stenosis. This characteristic ECG pattern is a sign of impending myocardial infarction and is equivalent to ST-elevated myocardial infarction. Often, these subtle findings in ECG get misinterpreted or the severity associated with this goes unrecognized. Hence, for emergency physicians, it is important to recognize such uncharacteristic ECG changes for better and timely management of patients. We present this case of Wellen's pattern in which the coronary lesion was in the left circumflex coronary artery, right coronary artery, and diagonal-1.
韦伦综合征与左前降支冠状动脉严重狭窄有关。根据心电图(ECG)模式,韦伦综合征可分为1型(主要在V2和V3导联出现深倒置T波)或2型(双向T波)。T波异常也常出现在V1和V4导联,很少出现在V5和V6导联。心电图变化模式与左前降支近端狭窄相关。这种特征性心电图模式是即将发生心肌梗死的迹象,等同于ST段抬高型心肌梗死。通常,心电图中的这些细微发现会被误解,或者与之相关的严重程度未被认识到。因此,对于急诊医生来说,识别这种不典型的心电图变化对于更好、及时地管理患者很重要。我们展示了这个韦伦模式的病例,其中冠状动脉病变位于左旋支冠状动脉、右冠状动脉和第一对角支。