Yr4 GenMed - Lectures

Question 1

What is Wellens Syndrome?

Answer 1

Wellens Syndrome is a clinical syndrome characterised by biphasic or deeply inverted T waves in V2-3, plus a history of recent chest pain now resolved. It is highly specific for critical stenosis of the left anterior descending artery (LAD).
- The pattern is usually present in the pain free state — it may be obscured during episodes of ischaemic chest pain, when there is “pseudonormalisation” of T waves in V2-3.
- Patients may be pain free by the time the ECG is taken, and have normal or minimally elevated cardiac enzymes. However, they are at extremely high risk for extensive anterior wall MI within the subsequent days to weeks
- Due to the critical LAD stenosis, these patients usually require invasive therapy, do poorly with medical management, and may suffer MI or cardiac arrest if inappropriately stress tested