Publicação
Wellens' Syndrome: A Bad Omen
| Resumo: | Wellens' syndrome is characterized by an electrocardiographic pattern of T-wave changes associated with a critical stenosis of the left anterior descending artery (LAD), which progresses to an extensive anterior myocardial infarction in the majority of cases. For this reason, its recognition and early treatment are extremely important. We report 2 cases of Wellens' syndrome: an 83-year-old male presenting with ill-characterized chest pain, biphasic T waves in V1-V3 during an asymptomatic period, negative cardiac biomarkers, and a 64% stenosis in LAD with a fractional flow reserve of 0.96 who fared well on medical therapy, and an 67-year-old male with typical angina pain, biphasic T waves in V2-V4 during asymptomatic periods, anterior ST-segment elevation at 2 min of effort during an exercise stress test, positive high-sensitivity cardiac troponin, and an 80% stenosis in the proximal LAD who was submitted to percutaneous coronary intervention which rendered him asymptomatic. The spectrum of Wellens' syndrome is very wide, and knowledge and high clinical suspicion for its diagnosis, especially in its rarest presentation of biphasic T waves, is key to avoiding catastrophic consequences. |
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| Autores principais: | Coutinho Cruz, M |
| Outros Autores: | Luiz, I; Ferreira, L; Cruz Ferreira, R |
| Assunto: | Aged Aged, 80 and over Angina Pectoris Chest Pain Coronary Angiography Coronary Stenosis Diagnosis, Differential Electrocardiography Exercise Test Humans Male Syndrome Troponin HSM CAR |
| Ano: | 2017 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Centro Hospitalar de Lisboa Central, EPE (CHLC) |
| Idioma: | inglês |
| Origem: | Repositório do Centro Hospitalar de Lisboa Central, EPE |
| Resumo: | Wellens' syndrome is characterized by an electrocardiographic pattern of T-wave changes associated with a critical stenosis of the left anterior descending artery (LAD), which progresses to an extensive anterior myocardial infarction in the majority of cases. For this reason, its recognition and early treatment are extremely important. We report 2 cases of Wellens' syndrome: an 83-year-old male presenting with ill-characterized chest pain, biphasic T waves in V1-V3 during an asymptomatic period, negative cardiac biomarkers, and a 64% stenosis in LAD with a fractional flow reserve of 0.96 who fared well on medical therapy, and an 67-year-old male with typical angina pain, biphasic T waves in V2-V4 during asymptomatic periods, anterior ST-segment elevation at 2 min of effort during an exercise stress test, positive high-sensitivity cardiac troponin, and an 80% stenosis in the proximal LAD who was submitted to percutaneous coronary intervention which rendered him asymptomatic. The spectrum of Wellens' syndrome is very wide, and knowledge and high clinical suspicion for its diagnosis, especially in its rarest presentation of biphasic T waves, is key to avoiding catastrophic consequences. |
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