Abstract
Wellens? syndrome, also known as LAD (left anterior descending) coronary T-wave syndrome, ?widow maker? or warning sign, is a potentially unrecognized critical proximal LAD stenosis with possible fatal consequences. It can be associated with extensive acute anterior wall myocardial infarction, with left ventricular dysfunction and a lethal outcome within a few days after the onset of symptoms. It usually consists of a typical ECG finding in the precordial leads that represents a significant proximal LAD stenosis in patients with unstable angina pectoris. Although this syndrome is not indicated for PCI (the patient is usually pain-free at the time of electrocardiography registration), it is necessary to recognize the characteristic pattern and perform an emergency coronary angiography and percutaneous or surgical revascularisation of the affected blood vessel. Here we present the case report of a 47 year-old woman without previous anamnesis of coronary disease. On admission to the Coronary Care Unit she was chest pain-free and had all the indicators of Wellens? syndrome.
Highlights
Wellens’ syndrome, “SQ” syndrome, LAD coronary T-wave syndrome, or “widow maker” are synonymous for the characteristic ECG pattern observed in patients with unstable angina pectoris in a chest pain-free period
Diagnosis is based on ST segment changes in anterior precordial leads, i.e. deep symetric inverted or biphasic T-waves, with or without minimal ST elevation (
The consequence of failure to recognize these subtle electrocardiographic patterns is an extensive acute anterior wall myocardial infarction within a few days after the onset of symptoms (Stambuk et al, 2010; Tandy et al, 1999). This can be followed by left ventricular dysfunction, malignant rhythm disorders and an often lethal outcome
Summary
Wellens’ syndrome, “SQ” syndrome, LAD coronary T-wave syndrome, or “widow maker” are synonymous for the characteristic ECG pattern observed in patients with unstable angina pectoris in a chest pain-free period. It is a sign of critical proximal LAD stenosis. Recognition of Wellens’ syndrome is imperative considering that 75% (Ayman et al, 2001; Stambuk et al, 2010) of patients develop an extensive acute anterior wall myocardial infarction within a few days after the onset of symptoms This case report is interesting because it relates to a patient with no prior history of heart disease and with chest pain
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
