The “widow maker” warning sign or Wellens’ syndrome: A case report

Karadzic, M.; Vuckovic-Filipovic, J.; Davidović, Goran; Irić-Ćupić, Violeta; Tasic, Mladen; Kovačević, Zoran

doi:10.2298/abs1202733k

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…In clinical practice it is essential to be able to read and recognize any ECG pattern suggestive of jeopardized myocardium to appropriately address and manage the situation in a timely manner. Wellens pattern has already been called a “widow-maker syndrome” [ 3 ] because it usually signals a premyocardial infarction status. Hence, Wellens sign has major diagnostic and prognostic significance.…”

Section: Discussionmentioning

confidence: 99%

Myocardial bridging—an unusual cause of Wellens syndrome

et al. 2020

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Rationale: Coronary chest pain is usually ischemic in etiology and has various electrocardiographic presentations. Lately, it has been recognized that myocardial bridging (MB) with severe externally mechanical compression of an epicardial coronary artery during systole may result in myocardial ischemia. Such a phenomenon can be associated with chronic angina pectoris, acute coronary syndromes (ACS), coronary spasm, ventricular septal rupture, arrhythmias, exercise-induced atrioventricular conduction blocks, transient ventricular dysfunction, and sudden death. Patient concerns: We report the case of a 58-year-old woman presenting with recurrent episodes of constrictive chest pain during exercise within the last 2 weeks. Except for obesity, general and cardiovascular clinical examination on admission were normal. Diagnoses: The resting 12 lead electrocardiogram (ECG) revealed changes typically for Wellens syndrome. High-sensitive cardiac troponin I was normal. We established the diagnosis of low-risk non-ST-segment elevation acute coronary syndrome with a Global Registry of Acute Coronary Events risk score of 92 points. Interventions: The patient underwent coronary angiography, who showed subocclusive dynamic obstruction of the left anterior descending artery due to MB. Outcomes: The patient was managed conservatively. Her hospital course was uneventful and she was discharged on pharmacological therapy (clopidogrel, bisoprolol, amlodipine, atorvastatin, and metformin) with well-controlled symptoms on followup. Lessons: MB is an unusual cause of myocardial ischemia. Wellens syndrome is an unusual presentation of ACS. We present herein a rare case of Wellens syndrome caused by MB. This case highlights the importance of subtle and frequently overseen ECG findings when assessing patients with chest pain and second, the importance of considering nonatherosclerotic causes for ACS.

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Section: Discussionmentioning

confidence: 99%

Myocardial bridging—an unusual cause of Wellens syndrome

et al. 2020

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“…Treatment WS is the pre-infarct stage of acute coronary syndrome; therefore, recognizing this syndrome can be a life-saving diagnosis. 17 T-wave changes in WS are usually observed in asymptomatic patients. Although these patients may initially respond well to medical management, they ultimately have poor outcomes with conservative therapy and require a revascularization strategy.…”

Section: Diagnosismentioning

confidence: 99%

Wellens Syndrome: A Review Article

Sahitra

Haizil

2022

Int J Res Rev

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Wellens syndrome is a pre-infarct stage of coronary syndrome and a clinical condition associated with left descending proximal anterior artery stenosis. Diagnostic criteria for Wellens syndrome include clinical history, ECG changes, and laboratory results. The pathognomonic ECG of Wellens syndrome is anterior inverted T-wave in precordial leads, which can be seen during pain-free period, accompanied by isoelectric or minimally elevated ST segment (<1 mm), no precordial Q waves, and normal or slightly elevated cardiac serum markers. Early diagnosis leads to early management and a better prognosis. Early management of Wellens syndrome involves maintaining an airway, breathing, circulation, monitoring vital signs, and medical management. Still, the only definitive management is urgent cardiac angiography to prevent further myocardial ischemia. The combination of early diagnostic and appropriate management will reduce complications and mortality rates. Keywords: Wellens Syndrome, Acute Coronary Syndromes, pre-Infarct MI.

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Wellens Syndrome, an Impending Doom: A Case Report

Benitez

2020

PJC

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BACKGROUND: Wellens syndrome, also known as “widow maker,” was first described by de Zwaan et al as a pattern of electrocardiographic changes for patients with significant left anterior descending coronary artery infarction. Early recognition could prevent an extensive infarction of the anterior wall, which could possibly lead to the demise of the patient. We present the case of a 60-year-old man who presented with sudden onset of chest pain with diaphoresis and cold clammy extremities. He was initially managed as a case of unstable angina. Further workup, which included serial electrocardiograms, led to the diagnosis of Wellens syndrome. The patient also underwent coronary angiography and angioplasty with good outcome. The patient’s course and a review of literature on Wellens syndrome are reported in this article.

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The “widow maker” warning sign or Wellens’ syndrome: A case report

Cited by 3 publications

References 4 publications

Myocardial bridging—an unusual cause of Wellens syndrome

Myocardial bridging—an unusual cause of Wellens syndrome

Wellens Syndrome: A Review Article

Wellens Syndrome, an Impending Doom: A Case Report

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