Wellens’ Syndrome Depicted by Coronary CT Angiography

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Abstract

Introduction: Wellens’ Syndrome is indicated by deeply inverted or biphasic T-waves in V2-V3 precordial leads without ST elevation or pathological Q waves, immediately following an episode of angina pectoris.

Case presentation: A case of Wellens’ syndrome depicted by coronary CT angiography (CTA) and invasive coronary angiography is reported.

Conclusion: Recognition of these ECG changes is important, due to the imminent danger of acute LAD occlusion. Patients with Wellens’ syndrome should undergo invasive coronary angiography without delay. Ischemia provocation tests (i.e. treadmill) are contraindicated in these patients.

1. Maurovich-Horvat P, Ferencik M, Voros S, Merkely B, Hoffmann U. Comprehensive plaque assessment by coronary CT angiography. Nat Rev Cardiol. 2014;11:390-402. doi: 10.1038/nrcardio.2014.60.

2. de Zwaan C, Bär FW, Wellens HJ. Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction. Am Heart J. 1982;103:730-736.

3. Sheng FQ, He MR, Zhang ML, Shen GY. Wellens syndrome caused by spasm of the proximal left anterior descending coronary artery. J Electrocardiol. 2015;48:423-425. doi: 10.1016/j.jelectrocard.2015.03.009.

4. Hollar L, Hartness O, Doering T. Recognizing Wellens’ syndrome, a warning sign of critical proximal LAD artery stenosis and impending anterior myocardial infarction. J Community Hosp Intern Med Perspect. 2015;5:29384. doi: 10.3402/jchimp.v5.29384.

5. Benedek T, Maurovich-Horváth P, Ferdinandy P. The use of biomarkers for the early detection of vulnerable atherosclerotic plaques and vulnerable patients. Journal of Cardiovascular Emergencies. 2016;2:106–113. doi: 10.1515/jce-2016-0017.

6. Benedek T, Jako B, Benedek I. Plaque quantification by Coronary CT and Intravascular Ultrasound Identifies a Low CT Density Core as a Marker of Plaque Instability in Acute Coronary Syndromes. Int Heart J. 2014;55:22-28.

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