Wellens syndrome associated with prominent anterior QRS forces: an expression of left septal fascicular block?
Wellens syndrome is a clinical-electrocardiographic entity also referred to as left anterior descending (LAD) coronary T-wave syndrome or acute coronary T-wave syndrome. It is a complex of symptoms and signals indicating the existence of an undesirable condition secondary to critical high-grade proximal stenosis of the LAD coronary artery characterized by the association of prior history of acute coronary syndrome with little or no elevation of markers of myocardial damage (unstable angina) and characteristic electrocardiographic changes consistent with subepicardial anterior ischemic pattern (persistently symmetrical, deep negative and broad-based T waves) or plus-minus T waves with inversion of the terminal portion in the LAD coronary artery territory (V1 through V5 or V6). We present a case of a variant of Wellens syndrome that reveals association and, transitorily, the criteria described in literature for left septal fascicular block.
Riera
Andrés Ricardo Pérez
AR
ABC Faculty of Medicine, Foundation of ABC, Santo André, São Paulo, Brazil. riera@uol.com.br
Ferreira
Celso
C
Ferreira Filho
Celso
C
Dubner
Sergio
S
Schapachnik
Edgardo
E
Uchida
Augusto H
AH
Moffa
Paulo
P
Zhang
Li
L
de Luna
Antoni Bayes
AB
D054058:Acute Coronary Syndrome / Q000175:diagnosis*; D000368:Aged; D002037:Bundle-Branch Block / Q000175:diagnosis*; D023921:Coronary Stenosis / Q000175:diagnosis*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006346:Heart Septum; D006801:Humans