title: Wellens syndrome associated with prominent anterior QRS forces: an expression of left septal fascicular block?
abstract: 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.
authors.affiliation: ABC Faculty of Medicine, Foundation of ABC, Santo André, São Paulo, Brazil. riera@uol.com.br
authors.forename: Andrés Ricardo Pérez
authors.initials: AR
authors.lastname: Riera
authors.forename: Celso
authors.initials: C
authors.lastname: Ferreira
authors.forename: Celso
authors.initials: C
authors.lastname: Ferreira Filho
authors.forename: Sergio
authors.initials: S
authors.lastname: Dubner
authors.forename: Edgardo
authors.initials: E
authors.lastname: Schapachnik
authors.forename: Augusto H
authors.initials: AH
authors.lastname: Uchida
authors.forename: Paulo
authors.initials: P
authors.lastname: Moffa
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Antoni Bayes
authors.initials: AB
authors.lastname: de Luna
mesh_terms: 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