Advertisement
Clinical Communications: Adults| Volume 43, ISSUE 4, P667-670, October 2012

Rapid Progression of Wellens Syndrome in the Emergency Department

      Abstract

      Background: In 1982, Wellens and colleagues described characteristic electrocardiogram (ECG) findings in angina patients virtually pathognomonic for significant stenosis of the proximal left anterior descending coronary artery and associated with a high risk of acute anterior wall myocardial infarction. Case Report: We present the case of a 74-year-old emergency department patient with classic ECG findings of Wellens syndrome and progression to acute ST elevation within 55 min. Summary: We present this case to increase awareness among emergency physicians of the characteristic findings of Wellens syndrome.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • De Zwaan C.
        • Bär W.H.M.
        • Wellens H.J.J.
        Characteristic electrocardiographic pattern indicating a critical stenosis high in the left anterior descending coronary artery in patients admitted because of impending myocardial infarction.
        Am Heart J. 1982; 103: 730-736
        • Conover M.B.
        Understanding electrocardiography.
        in: 8th edn. Mosby, St. Louis, MO2003: 301-315
        • Moore K.L.
        • Dalley A.F.
        Thorax.
        in: Clinically oriented anatomy. 4th edn. Lippincott Williams & Wilkins, Baltimore, MD1999: 347-351
        • Tandy T.K.
        • Bottomy D.P.
        • Lewis J.G.
        Wellens' syndrome.
        Ann Emerg Med. 1999; 33: 347-351
        • Aufderheide T.P.
        • Gibler W.B.
        Acute ischemic coronary syndromes.
        in: Rosen P. Barkin R. Emergency medicine: concepts and clinical practice. 4th edn. Mosby–Year Book, St Louis1998: 1688-1691
        • Haines D.E.
        • Raabe D.S.
        • Gundel W.D.
        • Wackers T.
        Anatomic and prognostic significance of new T-wave inversion in unstable angina.
        Am J Cardiol. 1983; 52: 14-18
        • De Zwann C.
        • Bar F.W.
        • Janssen J.H.
        • et al.
        Angiographic and clinical characteristics of patients with unstable angina showing an ECG pattern indicating critical narrowing of the proximal LAD coronary artery.
        Am Heart J. 1989; 117: 657-665
        • Rhinehardt J.
        • Brad W.J.
        • Perron A.D.
        • Mattu A.
        Electrocardiographic manifestations of Wellens' syndrome.
        Am J Emerg Med. 2002; 20: 638-643