Wellens' syndrome

Definition

1. A specific EKG abnormality in the precordial leads that is associated with critical stenosis of the LAD
2. Note this can be a TRANSIENT finding (will often persist for hours after pain resolved, then dissapear)

Criteria

Purely a T wave abnormality - no ST segment involement. If present in at least 2 leads of V1-V4 - 90% specificity for proximal LAD stenosisType 1 (classic) - deep symmetric t wave inversionsType 2 (less common) - biphasic t wave

Treatment

1. Pts typically present with angina/UA. Treat symptomatically ==Disposition==
2. This is highly specific - pts need a cardiac catheterization urgently

Source

Adapted from Marriott, Mattu (lecture)