Diallo Thierno Hamidou, Djafarou Boubacar Raynatou, Azday Illy Sawssen, Fellat Rokya, Fellat Nadia
Cardiology A Department, Ibn Sina University Hospital Center, Rabat, Morocco.
SAGE Open Med Case Rep. 2024 Dec 6;12:2050313X241271771. doi: 10.1177/2050313X241271771. eCollection 2024.
Traditionally reflecting critical stenosis of the proximal left anterior descending (LAD) artery, Wellens' syndrome (WS) is an electrocardiogram (ECG) pattern of biphasic or deeply inverted T waves in leads V2 and V3. This critical stenosis can progress to an extensive anterior myocardial infarction (MI) if early and appropriate management is not received promptly. The diagnosis of severe stenosis of the LAD coronary artery can be made by using electrocardiographic changes in Wellens' syndrome. Due to the significant area that the LAD vascularizes, patients who exhibit symptoms and test results suggestive of this syndrome should be referred right away for an angiographic exploration in order to confirm the diagnosis and guide treatment. We report a case of a 71-year-old male admitted to our department for acute chest pain. His ECG showed Wellens' syndrome type 2 during both chest pain and pain free with slightly elevated troponin. His TIMI score was 3 and the GRACE score was 136. Critical stenosis of the LAD coronary artery was found in the coronary angiography, which required a drug-eluting stent. The patient was discharged asymptomatic from medical therapy. The diagnosis was established on the basis of the patient's interview, ECG analysis, and coronary angiography.
韦伦斯综合征（WS）传统上反映左前降支（LAD）近端的严重狭窄，是V2和V3导联出现双向或深倒置T波的心电图（ECG）模式。如果不及早进行适当治疗，这种严重狭窄可能会进展为大面积前壁心肌梗死（MI）。LAD冠状动脉严重狭窄的诊断可通过韦伦斯综合征的心电图变化来做出。由于LAD供血的区域很大，出现提示该综合征症状和检查结果的患者应立即转诊进行血管造影检查，以确诊并指导治疗。我们报告一例71岁男性因急性胸痛入住我科。他的心电图在胸痛发作时和胸痛缓解时均显示为2型韦伦斯综合征，肌钙蛋白略有升高。他的TIMI评分为3分，GRACE评分为136分。冠状动脉造影发现LAD冠状动脉严重狭窄，需要植入药物洗脱支架。患者经药物治疗后无症状出院。诊断是根据患者的病史、心电图分析和冠状动脉造影确定的。
