title: Wellens syndrome: a life-saving diagnosis.
abstract: The diagnosis of acute coronary syndrome relies on clinical history, electrocardiographic (ECG) changes, and cardiac biomarkers; but within the spectrum of acute coronary syndrome, there exist subtle presentations that cannot afford to be overlooked. Wellens syndrome is one such example, in which a patient can present with both ECG changes that are not classic for myocardial ischemia and negative cardiac biomarkers. The characteristic ECG findings associated with Wellens syndrome consist of deep, symmetric T-wave inversions in the anterior precordial leads. However, Wellens syndrome can also present as biphasic T-wave inversions in those same ECG leads. The associated critical stenosis of the proximal left anterior descending artery carries an immediately life-threatening prognosis if not recognized promptly (Am Heart J. 1982;103[4 Pt 2]:730-736). We describe a case of a less common manifestation of Wellens syndrome (type 1) followed by a discussion of its implications and management.
authors.affiliation: Department of Medicine, University of Chicago Medical Center, Chicago, IL 60637, USA.
authors.forename: Kishan S
authors.initials: KS
authors.lastname: Parikh
authors.forename: Rajiv
authors.initials: R
authors.lastname: Agarwal
authors.forename: Amit K
authors.initials: AK
authors.lastname: Mehrotra
authors.forename: Rajiv S
authors.initials: RS
authors.lastname: Swamy
mesh_terms: D002637:Chest Pain / Q000209:etiology; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D006321:Heart / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013577:Syndrome