title: Angiocardiographic findings in patients with biphasic T-wave inversion in precordial leads.
abstract: OBJECTIVE
  To determine the angiocardiographic findings in patients with unstable angina showing biphasic inversion of T-waves in precordial leads on electrocardiogram, commonly referred to as the Wellen's syndrome.
  
  
  METHODS
  The descriptive, cross-sectional study was carried out at the National Institute of Cardiovascular Diseases, Karachi, between February and November, 2010. Using convenience sampling, the first 100 consecutive patients showing the characteristic electrocardiogram pattern with a history of chest pain indicative of unstable angina and undergoing coronary angiography were included. Data was collected with the aid of a questionnaire to assess the coronary risk factors, and angiographic findings were recorded during cardiac catherisation of the patients. All the data collected was sorted and analysed on SPSS version 16 for statistical analysis.
  
  
  RESULTS
  Biphasic T-wave inversion was seen most commonly in leads v2-v3 in 26 (26%) patients, and in leads v2-v4 in 25 (25%) patients. Angiographic findings revealed that 50 (50%) patients had coronary artery stenosis in the proximal part of the left anterior descending artery, while 22 (22%) showed the occlusion in the middle segment. Right coronary artery established the dominance of heart in 75 (75%) of the patients and the two-vessel disease was most commonly observed during cardiac catherisation.
  
  
  CONCLUSIONS
  The classical pattern of biphasic T-wave inversion on electrocardiogram was seen associated with stenosis in the proximal as well as middle part of the left anterior descending coronary artery. This electrocardiogram pattern may not be well defined during the symptomatic phase of acute ischaemia and, hence, maybe overlooked. Prompt recognition and early intervention may significantly reduce morbidity and mortality in such patients.
authors: National Institute of Cardiovascular Diseases, Karachi.
authors: Parveen
authors: P
authors: Akhtar
authors: Syed Nadeem Hassan
authors: SN
authors: Rizvi
authors: Faryal
authors: F
authors: Tahir
authors: Danish
authors: D
authors: Saleem
authors: Juwairia
authors: J
authors: Mulla
authors: Tahir
authors: T
authors: Saghir
mesh_terms: D000789:Angina, Unstable / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013577:Syndrome