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Wellen's Syndrome

Year 2010, Volume: 2 Issue: 2, 47 - 49, 01.08.2010

Abstract

Wellens' syndrome describes a characteristic pattern of ECG T-wave changes in association with critical narrowing of the left anterior descending coronary artery. Failure to diagnose this condition, with subsequent inappropriate management, may have fatal consequences. We report the case of a 55 year old male patient without any known cardiac disease with an ECG that demonstrates the classic Wellen's T-waves that was unrecognized. One week later he came to emergency department complaining severe chest pain. His ECG findings appropriate with anterior myocardial infarction which was treated with primary percutaneous intervention. This case highlights the importance of recognizing this kind of changes because patients with Wellens' syndrome are at high risk for the development of extensive myocardial infarction of the anterior wall and death.

References

  • Haines DE, Raabe DS, Gundel WD, Wackers FJ.: Anato mic and prognostic significance of new T-wave inversi on in unstable angina. Am J Cardiol 1983; 52: 14 – 18.
  • 2)Yamaji H, Iwasaki K, Kusachi S, Murakami T,Hirami R, Hamamoto H, et al.: Prediction of acute left main coro nary artery obstruction by 12-lead electrocardiography. ST segment elevation in lead aVR with less ST segment elevation in lead V1. J Am Coll Cardiol 2001;38:1348- 1354.
  • 3)Strauss BH, Green M.: Electrocardiographic prediction of ejection fraction and site of LAD occlusion in anteri or myocardial infarction. Clin Cardiol 1993; 16: 213 – 217.
  • 4)de Zwaan C, Bar FW, Wellens HJJ.: Characteristic elec- trocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in pati ents admitted because of impending myocardial infarction. Am Heart J 1982;103: 730-736.
  • 5)Tandy TK, Bottomy DP, Lewis JG.: Wellens’ syndrome. Ann Emerg Med 1999;33:347-351.
  • 6)de Zwaan C, Bar FW, Janssen JH, Cheriex EC, Dassen WR, Brugada P, et al.: Angiographic and clinical charac- teristics of patients with unstable angina showing an ECG pattern indicating critical narrowing of the proxi mal LAD coronary artery. Am Heart J 1989;117:657- 665.
  • 7)Patanè S, Marte F.: Wellens' syndrome and other elec- trocardiographic changes in a patient with a left anteri or descending artery subocclusion associated with a left main coronary artery subocclusion. Int J Cardiol. 2009 Mar 31. [Epub ahead of print]
  • 8)Nisbet B, Zlupko G. Repeat Wellens' syndrome.: Case report of critical proximal left anterior descending artery restenosis. J Emerg Med 2010;39:305-308
  • 9)Rhinehardt J, Brady WJ, Perron AD, Mattu A.: Electro- cardiographic manifestations of Wellens’ syndrome.Am J Emerg Med 2002;20:638-643.

Wellen Sendromu

Year 2010, Volume: 2 Issue: 2, 47 - 49, 01.08.2010

Abstract

Wellen sendromu aralıklı göğüs ağrısı olan bir hastada ağrısız periyodlarda gözlemlenen T dalga değişiklikleriyle karakterize bir klinik durumdur. Bu bulgu yakın bir zamanda anterior miyokard infarktüsüne MI sebep olacak olan sol ön inen arter LAD proksimalindeki kritik derecede bir darlığın varlığına işaret eder. Biz bilinen kardiyak bir hastalığı olmayan 55 yaşında erkek hastanın EKG'sindeki klasik Wellens T dalgalarının varlığı sonrasında gelişen akut anterior MI olgusunu sunmaktayız. Hasta bir hafta önce göğüs ağrısı şikayetiyle bir dış merkeze başvurmuş ve EKG'sinde anormal T dalgaları saptanmıştır. Serum kardiyak belirteçleri normal düzeyde bulunmuştur. Şikayetleri gerileyen hasta kardiyoloji poliklinik kontrolü önerilerek taburcu edilmiştir. Bir hafta sonra acil servisimize göğüs ağrısı ve anterior MI ile uyumlu EKG bulgularıyla başvuran hasta, ivedilikle kateter laboratuvarına alınarak LAD proksimalindeki %99 darlığa primer perkütan girişim uygulanmıştır. Eğer Wellens'in T dalga değişiklikleri önceden fark edilebilseydi anterior MI önlenebilirdi.

References

  • Haines DE, Raabe DS, Gundel WD, Wackers FJ.: Anato mic and prognostic significance of new T-wave inversi on in unstable angina. Am J Cardiol 1983; 52: 14 – 18.
  • 2)Yamaji H, Iwasaki K, Kusachi S, Murakami T,Hirami R, Hamamoto H, et al.: Prediction of acute left main coro nary artery obstruction by 12-lead electrocardiography. ST segment elevation in lead aVR with less ST segment elevation in lead V1. J Am Coll Cardiol 2001;38:1348- 1354.
  • 3)Strauss BH, Green M.: Electrocardiographic prediction of ejection fraction and site of LAD occlusion in anteri or myocardial infarction. Clin Cardiol 1993; 16: 213 – 217.
  • 4)de Zwaan C, Bar FW, Wellens HJJ.: Characteristic elec- trocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in pati ents admitted because of impending myocardial infarction. Am Heart J 1982;103: 730-736.
  • 5)Tandy TK, Bottomy DP, Lewis JG.: Wellens’ syndrome. Ann Emerg Med 1999;33:347-351.
  • 6)de Zwaan C, Bar FW, Janssen JH, Cheriex EC, Dassen WR, Brugada P, et al.: Angiographic and clinical charac- teristics of patients with unstable angina showing an ECG pattern indicating critical narrowing of the proxi mal LAD coronary artery. Am Heart J 1989;117:657- 665.
  • 7)Patanè S, Marte F.: Wellens' syndrome and other elec- trocardiographic changes in a patient with a left anteri or descending artery subocclusion associated with a left main coronary artery subocclusion. Int J Cardiol. 2009 Mar 31. [Epub ahead of print]
  • 8)Nisbet B, Zlupko G. Repeat Wellens' syndrome.: Case report of critical proximal left anterior descending artery restenosis. J Emerg Med 2010;39:305-308
  • 9)Rhinehardt J, Brady WJ, Perron AD, Mattu A.: Electro- cardiographic manifestations of Wellens’ syndrome.Am J Emerg Med 2002;20:638-643.
There are 9 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Alper Aydın This is me

Tayfun Gürol This is me

Mustafa Serdar Yılmazer This is me

Yusuf Selçuk Yıldız This is me

Osman Akdemir This is me

Bahadır Dağdeviren This is me

Publication Date August 1, 2010
Published in Issue Year 2010 Volume: 2 Issue: 2

Cite

Vancouver Aydın A, Gürol T, Yılmazer MS, Yıldız YS, Akdemir O, Dağdeviren B. Wellen Sendromu. Maltepe tıp derg. 2010;2(2):47-9.