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Case Reports
. 2020 Jul;24(14):7718-7721.
doi: 10.26355/eurrev_202007_22275.

Wellens Syndrome without chest pain, is it possible?

E Torelli  1 , F Sardeo, E Nuzzo, S Cicchinelli, M Petrucci, G Pignataro, M Covino, F Franceschi, M Candelli
Affiliations
Free article
Case Reports

Wellens Syndrome without chest pain, is it possible?

E Torelli et al. Eur Rev Med Pharmacol Sci. 2020 Jul.
Free article

Abstract

Objective: Wellens syndrome is a typical electrocardiographic and clinical pattern that correlates with a severe proximal stenosis of the left anterior descending artery (LAD). It is associated with previous angina, no or slightly increased cardiac markers, and two ECG patterns: diphasic T wave in V2-V3 (Type A) or deep negative T waves from V1 to V4 (type B). In this paper, we described two cases with asymptomatic Wellens patterns.

Patients and methods: We describe two cases of Wellens syndrome ECG pattern that we observed in our Emergency Department not accompanied by chest pain or angina equivalents.

Results: Both patients presented significant stenosis of LAD at the coronary angiography.

Conclusions: Asymptomatic patients presenting with Wellens ECG pattern should perform a coronary arteriography cause of the risk of a severe LAD stenosis. We need further studies to confirm if all "silent" Wellens syndromes deserve angiographic study.

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