Tolu-Akinnawo Oluwaremilekun, Dufera Rabira R, Akamah Joseph
Internal Medicine, Meharry Medical College, Nashville, USA.
Cardiology, Nashville General Hospital, Nashville, USA.
Cureus. 2023 Mar 28;15(3):e36820. doi: 10.7759/cureus.36820. eCollection 2023 Mar.
Wellens syndrome is a unique electrocardiographic (ECG) pattern usually suggestive of critical stenosis of the left anterior descending (LAD) coronary artery. Providers must recognize this pattern as it frequently occurs in symptom-free periods and represents a pre-infarction stage requiring early intervention. We present the case of a 39-year-old male with a past medical history of hypertension who was brought to the emergency department due to complaints of worsening recurrent intermittent squeezing left-sided chest pain of two months duration. Cardiac enzymes were within limits. ECG done at triage was significant for biphasic T waves in leads V2-V5 consistent with type A Wellens syndrome. The cardiology team consulted, with the patient subsequently having a percutaneous coronary intervention to the mid and proximal portion of the LAD. The patient was later discharged on the third day of admission on guideline-directed medical therapy, with plans to follow up closely with the cardiology clinic. This case highlights the significance of using the characteristics pattern of Wellens syndrome in providing critical diagnostic and prognostic value. This article aimed to promote awareness of Wellens syndrome, the clinical correlation, and the role of timely acute management.
Wellens综合征是一种独特的心电图（ECG）模式，通常提示左前降支（LAD）冠状动脉严重狭窄。医护人员必须认识到这种模式，因为它经常出现在无症状期，代表着需要早期干预的梗死前期。我们报告一例39岁男性病例，该患者有高血压病史，因反复出现持续两个月的左侧胸部间歇性压榨性疼痛加重而被送往急诊科。心肌酶在正常范围内。分诊时进行的心电图显示，V2-V5导联出现双相T波，符合A型Wellens综合征。心内科团队会诊后，患者随后接受了LAD中、近端的经皮冠状动脉介入治疗。患者在入院第三天在指南指导下接受药物治疗后出院，并计划在心内科门诊密切随访。该病例强调了利用Wellens综合征的特征性模式提供关键诊断和预后价值的重要性。本文旨在提高对Wellens综合征、临床相关性以及及时急性处理作用的认识。
