Wellens' syndrome

Background

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

Criteria

1. Prior history of chest pain
2. Little or no cardiac enzyme elevation
3. No pathologic precordial Q waves
4. Little or no ST-segment elevation
5. No loss of precordial R waves
6. Biphasic T waves in leads V2 and V3 OR symmetric, often deeply inverted T waves in V2-V3
7. See example below :A) biphasic pattern and B) inversion pattern

Treatment

1. Urgent cardiac catheterization

Example

Source

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