title: A special case of Wellens' syndrome.
abstract: Wellens' syndrome is a pattern of electrocardiographic T-wave changes associated with critical stenosis of proximal left anterior descending artery (LAD). T-waves abnormalities were found in precordial leads, especially in V2-V3 during pain-free periods, and ECG obtained during episodes of pain demonstrates upright T-waves with possible elevated or isoelectric ST segments. Early recognition and appropriate intervention carries significant diagnostic and prognostic value. We reported a case of Wellens' syndrome with different etiology and prognosis. Although the ECG showed typical T-wave changes in V2-V5 leads, patient's coronary angiography revealed moderate stenosis in proximal LAD, and coronary artery spasm was suggested. Unlike the classic Wellens' syndrome, which needs aggressive coronary intervention, our patient fared well with conservative medical therapy (diltiazem and nitrates) and showed favorable prognosis.
authors.affiliation: Cardiology Department, Hospital of Armed Police Force of Xinjiang, No 669 South Nanchang Road, Urumqi, Xinjiang, China.
authors.forename: Alimujiang
authors.initials: A
authors.lastname: Abulaiti
authors.forename: Renaguli
authors.initials: R
authors.lastname: Aini
authors.forename: Hiarong
authors.initials: H
authors.lastname: Xu
authors.forename: Zejun
authors.initials: Z
authors.lastname: Song
keywords: Coronary artery spasm; Electrocardiography; Wellens syndrome
references.citation: Am Heart J. 1982 Apr;103(4 Pt 2):730-6
references.pmid: 6121481
references.citation: Am Heart J. 1989 Mar;117(3):657-65
references.pmid: 2784024
references.citation: Can J Cardiol. 2008 May;24(5):404
references.pmid: 18464948
references.citation: J Cardiol. 2008 Feb;51(1):2-17
references.pmid: 18522770
references.citation: Am J Emerg Med. 2006 Jan;24(1):122-3
references.pmid: 16338519
references.citation: J Emerg Med. 2010 Sep;39(3):305-8
references.pmid: 18394847
references.citation: Kardiol Pol. 2011;69(1):79-81; discussion 82
references.pmid: 21267975