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ECG spectrum in acute coronary syndrome
Published in K Sarat Chandra, AJ Swamy, Acute Coronary Syndromes, 2020
Ankit Bansal, Vivek Chaturvedi
There are two patterns of T wave abnormality in Wellens syndrome: Type A: Biphasic, with initial positivity and terminal negativity (25% of cases)Type B: Deeply and symmetrically inverted (75% of cases)
STEMI Equivalents and Their Incidence during EMS Transport
Published in Prehospital Emergency Care, 2022
Nicholas Palladino, Aman Shah, Jeffrey McGovern, Kevin Burns, Ryan Coughlin, Daniel Joseph, David C. Cone
Wellens syndrome was first described in 1982. Wellens syndrome criteria includes T-wave changes, lack of pathological Q-waves, normal progression of R-waves, and lack of ST elevation. These T-wave changes are defined as biphasic T-waves in V2-3 (Type A) or deeply inverted (Type B) (21). These T-wave abnormalities are continual and may be present for hour to weeks and are associated with critical stenosis of the left anterior descending artery (21). Risk factors for Wellens syndrome are similar to those for other cardiovascular diseases and include hypertension, hyperlipidemia, elevated cholesterol, diabetes, obesity, smoking, stress, and a sedentary lifestyle (22). In one of the earlier studies from Dr. Wellens in 1982, investigators looked at 145 patients admitted for unstable angina; 26 (18%) had ECG patterns consistent with Wellens syndrome, 4 with Wellens A and 22 with Wellens B (19). In follow-up study, 14% of patients with AMI were found to have these characteristic ECG changes. During cardiac catheterization, all patients with these characteristic ECG abnormalities were found to have significant LAD lesions (23).
Focus on cardiac rhythm disorders
Published in Acta Cardiologica, 2023
Patrizio Lancellotti, Caroline Piette
The Wellens’ syndrome is referred as a ECG pattern associated with deeply inverted or biphasic T waves in precordial leads mainly in V2-V3 that was considered to be pointed at critical stenosis or occlusion of proximal segment of the left anterior descending coronary artery in patients with unstable angina/acute coronary syndrome. Wellens’ Syndrome is independently associated with the appearance of cardiac complications during hospitalisation in patients with non-ST-segment elevation acute coronary syndrome (Figure 3) [13, 14].
Wellens syndrome as an independent predictor of in-hospital cardiovascular complications
Published in Acta Cardiologica, 2023
Luis Mariano de la Torre Fonseca, Robert Alarcón Cedeño, Víctor Alfonso Jiménez Díaz, Lin Wang, Fabiola Isabel Loor Cedeño, Pablo Juan-Salvadores
Wellens syndrome (WS) was first described in the 1980s by De Zaan, Wellens and collaborators [1], as an equivalent pattern of a critical lesion of the proximal anterior descending artery (ADA), which if left untreated could eventually evolve into a large infarction. These patients usually present to the emergency department without chest pain at the time of clinical evaluation and the markers of myocardial necrosis are within normal or slightly elevated ranges, which makes diagnosis and subsequent treatment difficult [2,3].