Wellens' syndrome: Difference between revisions

Revision as of 02:33, 23 August 2011

T wave abnormality that is associated with critical LAD stenosis
- Finding can be transient (Persist for hrs after pain has resolved and then dissapear)

Prior history of chest pain
Little or no cardiac enzyme elevation
No pathologic precordial Q waves
Little or no ST-segment elevation
No loss of precordial R waves
Biphasic T waves in leads V2 and V3 OR symmetric, often deeply inverted T waves in V2-V3
See Media:Wellens.jpg for example of A) biphasic pattern and B) inversion pattern

Wellens’ Syndrome. Annals of Emergency Medicine, March, 1999.

Authors:

@@ Line 1: / Line 1: @@
-==Definition==
+==Background==
-#A specific EKG abnormality in the precordial leads that is associated with critical stenosis of the LAD
+*T wave abnormality that is associated with critical LAD stenosis
-#Note this can be a TRANSIENT finding (will often persist for hours after pain resolved, then dissapear)
+**Finding can be transient (Persist for hrs after pain has resolved and 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
+#Prior history of chest pain
+#Little or no cardiac enzyme elevation
+#No pathologic precordial Q waves
+#Little or no ST-segment elevation
+#No loss of precordial R waves
+#Biphasic T waves in leads V2 and V3 OR symmetric, often deeply inverted T waves in V2-V3
+#See [[Media:Wellens.jpg]] for example of A) biphasic pattern and B) inversion pattern
 ==Treatment==
-#Pts typically present with angina/UA. Treat symptomatically ==Disposition==
+#Urgent cardiac catheterization
-#This is highly specific - pts need a cardiac catheterization urgently
 ==Source==
-Adapted from Marriott, Mattu (lecture)
+Wellens’ Syndrome. Annals of Emergency Medicine, March, 1999.
 [[Category:Cards]]