Wellens’ Syndrome: Case report

Öz

Wellens’ syndrome is a clinical picture characterized by T wave changes mostly observed in painless periods on electrocardiography as a result of the critical narrowing of the left anterior descending artery. In our case, a 57-year-old female was admitted to the emergency department with the complaint of intermittent atypical chest pain for two days. In the electrocardiography, negative T waves were observed in the anterior leads defined as Wellens’ syndrome. Cardiac enzyme markers were slightly elevated. The patient was evaluated as an acute coronary syndrome and was taken to the catheter laboratory. In coronary angiography, 99% critical stenosis was detected in the middle segment of the left anterior descending artery and percutaneous intervention was performed.

Anahtar Kelimeler

• Wellen’s syndrome
• myocardial infarction
• ECG
• T wave abnormality

Wellens Sendromu: Olgu sunumu

Öz

Wellens sendromu sol ön inen arterin (LAD) kritik daralmasın neticesinde elektrokardiyografide (EKG) çoğunlukla ağrısız periyodlarda izlenen T dalga değişiklikleri ile seyreden klinik tablodur. Vakamız 57 yaşında bayan hasta iki gündür aralıklı olan atipik göğüs ağrısı şikayeti ile acil servise başvurdu. EKG’de Wellens sendromu olarak tanımladığımız ön yüz derivasyonlarda negatif T dalgaları izlendi. Kardiyak enzim değerinde hafif yüksek tespit edildi. Hasta doğrudan koroner anjiyografi laboratuvarına alındı ve yapılan görüntülemede LAD orta segmentte %99 kritik darlık tespit edildi ve perkütan girişim yapıldı. Hasta komplikasyonsuz olarak taburcu edildi.

Anahtar Kelimeler

• Wellens sendromu
• miyokard infarktüsü
• elektrokardiyografi
• T dalga anormalliği

Kaynakça

1. de Zwaan C, Frits W. H. M. Bär, and Hein J. J. Wellens, “Characteristic electrocardiographic pattern indicating a critical stenosis high in le anterior descending coronary artery in patients admitted because of impending myocardial infarction,” American Heart Journal, vol. 103, no. 4, pp. 730–736, 1982.
2. de Zwaan C, Bar FW, Janssen JH, et al. Angiographic and clinical characteristics of patients with unstable angina showing an ECG pattern indicating critical narrowing of the proximal LAD coronary artery. Am Heart J. 1989 Mar. 117(3):657-65.
3. T. K. Tandy, D. P. Bottomy, and J. G. Lewis, “Wellens’ syndrome,” Annals of Emergency Medicine, vol. 33, no. 3, pp. 347–351, 1999
4. Rhinehardt J, Brady WJ, Perron AD, Mattu A. Electrocardiographic manifestations of Wellens' syndrome. Am J Emerg Med. 2002 Nov. 20(7):638-43.
5. Sowers N. Harbinger of infarction: Wellens syndrome electrocardiographic abnormalities in the emergency department. Can Fam Physician. 2013;59(4):365-6.