Open AccessUncommon Variant of Wellens’ Syndrome: A Case Report and Review of Literature
Author(s) -
Layal Mansour,
F Chammas,
Fida Charif,
Mohamad Jihad Mansour
Publication year - 2017
Publication title -
advanced emergency medicine
Language(s) - English
Resource type - Journals
ISSN - 2315-456X
DOI - 10.18686/aem.v6.110
Subject(s) - t wave , medicine , chest pain , emergency department , cardiology , acute coronary syndrome , myocardial infarction , troponin , cardiac catheterization , stenosis , electrocardiography , psychiatry
A 48-year-old male was admitted to the emergency department because of intermittent chest pain of 2 days duration. At the time of examination, he was pain-free. An electrocardiogram (ECG) showed biphasic T waves in leads V2 to V6. Troponin-I level was negative. During his transfer to the cardiac catheterization laboratory, he had a short episode of chest pain. His ECG was normal. Despite the unusual extension of biphasic T waves to the lateral precordial leads, the condition was recognized as Wellens’ syndrome, which typically associates biphasic or deep symmetric T wave inversion in leads V2 and V3 during pain-free periods with a critical stenosis in the proximal left anterior descending artery. The syndrome is uncommon to medical practice but should be recognized immediately in the emergency department because it represents a pre-infarction stage and carries a high risk of mortality.