A particular case of Wellens’ Syndrome

Chioncel, Valentin; Avram, Anamaria; Sinescu, Crina

doi:10.1016/j.mehy.2020.110013

Cited by 9 publications

(15 citation statements)

References 10 publications

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“…Wellens syndrome has the same risk factors as traditional acute coronary syndrome, including HTN, diabetes, hyperlipidemia, smoking, etc. [1][2][3][4]. Like previously recorded examples of Wellen's syndrome in several classic documentations [5][6][7][8][9], our patient had a history of high blood pressure, diabetes, and hyperlipidemia, which predisposed him to this pre-infarction condition, comparable to those that cause coronary artery disease.…”

Section: Discussionsupporting

confidence: 54%

“…Still, the cause of Wellens' syndrome remains unclear [5][6][7][8][9]. Furthermore, these ECG changes representing a preinfarction state are commonly associated with unstable angina [1][2][3][4]. Also, the exact electrophysiologic mechanism is unknown [1][2][3][4].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, these ECG changes representing a preinfarction state are commonly associated with unstable angina [1][2][3][4]. Also, the exact electrophysiologic mechanism is unknown [1][2][3][4]. While the exact electrophysiologic mechanism is unknown, the Wellens syndrome pattern may be evidence of temporary occlusion of the LAD coronary artery [2][3][4].…”

Section: Discussionmentioning

confidence: 99%

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Wellens Syndrome: A Possible Precursor

Okobi¹,

Bakare²,

Evbayekha³

et al. 2022

Cureus

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Wellens syndrome is a precursor of left anterior descending (LAD) coronary stenosis. It is characterized by biphasic T waves in V2-V3 (type A) or negative deep T waves in V2-V4 (type B). The ability of emergency physicians, hospitalists, or primary care providers to recognize these early ECG patterns is primordial because the definitive treatment is urgent cardiac catheterization with percutaneous coronary intervention. However, failure to identify a type A or type B Wellens syndrome may lead to devastating outcomes, such as myocardial infarction or even death. We presented a clinical case of Wellens' syndrome with deep T waves in V2-V3 associated with COVID pneumonia, pleural effusions, and congestive heart failure that went to a rapid and massive myocardial infarction.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Wellens Syndrome: A Possible Precursor

Okobi¹,

Bakare²,

Evbayekha³

et al. 2022

Cureus

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“…The pathophysiological mechanism underlying the characteristic T-wave changes in Wellens syndrome is debatable. Some studies have suggested that dynamic T-wave changes are caused by myocardial stunning or ventricular systolic dysfunction[ 15 , 16 ], whereas others have suggested that the pathophysiology is myocardial edema rather than myocardial dysfunction[ 17 ]. However, these studies have not clarified the mechanisms underlying the inverted or biphasic T-waves during the pain-free period, or the positive T-waves in the presence of angina.…”

Section: Discussionmentioning

confidence: 99%

Entire process of electrocardiogram recording of Wellens syndrome: A case report

Tang¹,

Li²,

Liang³

et al. 2022

WJCC

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BACKGROUND Wellens syndrome is an electrocardiogram (ECG) pattern seen in high-risk patients with unstable angina pectoris. It is characterized by inverted or biphasic T-waves that change into positive or pseudo-normalized waves at precordial leads when the patient experiences an angina attack; however, the mechanism for this condition remains unclear. CASE SUMMARY A 47-year-old male patient experienced repeated, unprovoked episodes of chest pain for > 20 d, with worsening during the previous day. On the day of admission, he experienced episodes of paroxysmal chest pain lasting more than 30 min, in addition to radiating pain to the left arm and exertional dyspnea. The patient presented to the emergency department with no chest pain or other discomfort at that time. ECG at presentation showed sinus tachycardia and T-wave changes, which were identified as Wellens syndrome when combined with previous ECG findings. ECGs and myocardial enzymology examinations were normal when angina was present, but the ECG showed inverted or biphasic T-waves when angina was absent. After percutaneous coronary intervention, the ECGs demonstrated inverted or biphasic T-waves in the anterior precordial leads on days 0, 1, and 2, but normal T-waves on day 3. The ECGs showed no subsequent ischemic ST-T-wave changes. CONCLUSION The Wellens syndrome pseudo-normalized T-waves likely reflect development of unstable angina pectoris into the hyperacute phase of ST-segment elevation myocardial infarction.

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“…66 Since inflammation is one of the main causes of stent thrombosis, 67 the systemic administration of anti-inflammatory or immunosuppressive therapy (oral steroids after PCI when a metal allergy is confirmed), in addition to double antiplatelet therapy, might be beneficial in suppressing the vascular inflammation and lowering the rates of stent thrombosis. [68][69][70] Konishi et al reported a case with recurrent stent thrombosis in a patient with proved stent allergy who can benefit of systemic corticotherapy. 71 Besides antiplatelet therapy, low doses of steroids might confer clinical benefits and lower the incidence of stent thrombosis due to their anti-inflammatory properties.…”

Section: Stent Thrombosis/kounis Syndromementioning

confidence: 99%

Some Perspectives on Hypersensitivity to Coronary Stents

Chioncel¹,

Andrei²,

Brezeanu³

et al. 2021

IJGM

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The development of coronary stents has represented a revolution in the treatment of coronary heart disease. Beyond their many advantages, stents also have their limitations and complications. Allergic reactions to coronary stents are more common than acknowledged. These stented patients are exposed to foreign substances inserted in direct contact with the coronary intima. Hypersensitivity to stent components and drugs prescribed after stent insertion together with any environmental exposure seem to contribute to these adverse reactions. Patients can present to the hospital with a wide range of symptoms and multiple complications, the most important ones being instent restenosis and stent thrombosis. Although not very common (and not always easy to identify), allergic reactions after coronary or peripheral stents should be taken into account. Careful selection of patients (for elective stent implantation) depending on the propensity to allergies, although hard to achieve, represents a key factor in reducing the number of these complications.

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A particular case of Wellens’ Syndrome

Cited by 9 publications

References 10 publications

Wellens Syndrome: A Possible Precursor

Wellens Syndrome: A Possible Precursor

Entire process of electrocardiogram recording of Wellens syndrome: A case report

Some Perspectives on Hypersensitivity to Coronary Stents

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