Arin Can Baba
Cardiology, Health Sciences University, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, TUR.
Cureus. 2025 Jul 1;17(7):e87110. doi: 10.7759/cureus.87110. eCollection 2025 Jul.
Cardiovascular complications, including myocardial ischemia, can occur during acute asthma exacerbations due to overlapping inflammatory and physiological mechanisms. ECG abnormalities and elevated cardiac biomarkers may mimic acute coronary syndrome, complicating diagnosis and management. We present a case of a 60-year-old woman with a history of long-standing asthma and hypertension who presented with chest pain and shortness of breath during an asthma exacerbation. Clinical evaluation revealed diffuse wheezing, deep T-wave inversions on ECG, and elevated cardiac biomarkers, initially raising concern for Wellens syndrome. Transthoracic echocardiography showed mild left ventricular hypertrophy and regional wall motion abnormalities, but coronary angiography demonstrated no obstructive coronary artery disease. The patient's symptoms and oxygen saturation improved with bronchodilator and corticosteroid therapy, supporting a diagnosis of pseudo-Wellens syndrome in the setting of status asthmaticus. This case highlights the importance of recognizing pseudo-Wellens syndrome as a potential mimic of true myocardial ischemia to avoid unnecessary invasive procedures and guide appropriate treatment.
由于炎症和生理机制重叠，在急性哮喘加重期间可能会出现包括心肌缺血在内的心血管并发症。心电图异常和心脏生物标志物升高可能会模仿急性冠状动脉综合征，使诊断和管理复杂化。我们报告一例60岁女性病例，该患者有长期哮喘和高血压病史，在哮喘加重期间出现胸痛和呼吸急促。临床评估发现弥漫性哮鸣音、心电图上深T波倒置以及心脏生物标志物升高，最初引起了对Wellens综合征的关注。经胸超声心动图显示轻度左心室肥厚和节段性室壁运动异常，但冠状动脉造影显示无阻塞性冠状动脉疾病。患者的症状和血氧饱和度通过支气管扩张剂和皮质类固醇治疗得到改善，支持在哮喘持续状态下诊断为假性Wellens综合征。该病例强调了认识假性Wellens综合征作为真正心肌缺血潜在模仿物的重要性，以避免不必要的侵入性操作并指导适当治疗。
