Electrocardiographic manifestations of Wellens' syndrome

Wellen's syndrome

“…It is necessery to recognize them, timely treatment to prevent the development of acute myocardial infarction and myocardial necrosis. [1][2][3] Simple criteria of Wellen , s syndroma:…”

“…Another important criteria is presence of precordial R and absence of pathological Q-wave .The origin of these ECG changes remains obscure, as they can persist for months, but it is most likely that they represent reperfusion. [6][7] Medical therapy in most of the cases is insufficient to prevent development of large myocardial infarction and demands early recognition and coronary percutaneous intervention. 8 The sign can be seen as a rare presentation of : -Takotsubo stress cardiomyopathy -Cocaine-induced vasospasm -Q and non Q myocardial infarction -Myocarditis -Pulmonary embolism -CV Stroke -WPW syndrome -in the presence of left ventricular hypertrophy ect.…”

“…Although, not one of the indication for pPCI, each patients with the typical ECG finding, should be considered for coronary angiography and reperfusion. [2][3][4] Case Report 72 years, male patient, F. V. was admitted to Coronary Care Unit because of recurrent chest pain from the previous day, duration of ten minutes. They were presented with the initial pain in the arms, shoulders with spread in the middle of the chest ("centripetal projection" ) unlike more frequent anginal pain presented by the "centrifugal pain projections" .…”

Wellens’ syndrome

“…T-wave changes in Wellens' syndrome are typically observed in asymptomatic patients. Although these patients may initially respond well to medical management, they ultimately fare poorly with conservative therapy and require revascularization strategies [1].…”

“…Occasionally, due to insidious evolution and pain-free intervals, provocative cardiac stress tests are performed in these patients with the implicit risk of developing acute myocardial infarction or sudden death [1,3].…”