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Case Reports
. 2022 May 20;14(5):e25158.
doi: 10.7759/cureus.25158. eCollection 2022 May.

Wellen's Syndrome: A Rare Case

Govind Nagdev  1 , Gajanan Chavan  1 , Gaurang M Aurangabadkar  2
Affiliations
Case Reports

Wellen's Syndrome: A Rare Case

Govind Nagdev et al. Cureus. .

Abstract

Wellen's syndrome is associated with critical stenosis of the left anterior descending coronary artery. Based on the electrocardiography (ECG) pattern, Wellen's syndrome can be classified into type 1 (deeply inverted T-waves, mainly in lead V2 and V3) or type 2 (biphasic T-waves). T-wave abnormalities are often also found in V1 and V4 and rarely in V5 and V6. The pattern of ECG changes correlates with proximal left anterior descending artery stenosis. This characteristic ECG pattern is a sign of impending myocardial infarction and is equivalent to ST-elevated myocardial infarction. Often, these subtle findings in ECG get misinterpreted or the severity associated with this goes unrecognized. Hence, for emergency physicians, it is important to recognize such uncharacteristic ECG changes for better and timely management of patients. We present this case of Wellen's pattern in which the coronary lesion was in the left circumflex coronary artery, right coronary artery, and diagonal-1.

Keywords: 2d echocardiography; coronary artery angiography; electrocardiography (ecg); left circumflex artery (lcx); wellen’s syndrome.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Biphasic T-waves in lead V2 and V3 (red arrows) (typical of type 1 Wellen’s syndrome) and symmetrically inverted T-waves in lead 1, aVL, V4-V6 (yellow arrows) (typical of type 2 Wellen’s syndrome) and Q-waves in lead 3 and aVF.
Figure 2
Figure 2. Coronary angiography showing evidence of critical stenosis (80%) in the right coronary artery territory.
RCA: right coronary artery
Figure 3
Figure 3. Coronary angiography post-stenting to the right coronary artery.
RCA: right coronary artery
See this image and copyright information in PMC

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