title: Wellens' syndrome can indicate high-grade LAD stenosis in case of left bundle branch block.
abstract: Diagnosing acute myocardial infarction (AMI) in left bundle branch block (LBBB) is challenging. Modified Sgarbossa criteria are known to help detect AMI in LBBB. This is a report about an electrocardiogram (ECG) with Wellens' signs in combination with a pre-existing LBBB. The ECG of a patient with fluctuating chest pain showed very subtle and one day later more obvious Wellens'signs. A left anterior descending artery (LAD) stenosis was diagnosed and successfully treated. Wellens' syndrome can be diagnosed in a case of LBBB and help detect a high-grade LAD stenosis even if modified Sgarbossa criteria are not met.
authors.affiliation: Emergency Department, Klinikum Herford, Schwarzenmoorstr. 70, 32049, Herford, Germany. steffen.grautoff@klinikum-herford.de.
authors.forename: Steffen
authors.initials: S
authors.lastname: Grautoff
mesh_terms: D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000628:therapy*; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000628:therapy*; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013577:Syndrome
keywords: Anterior wall myocardial infarction; ECG; Left anterior descending artery stenosis; Left bundle branch block; Wellens’ syndrome