User:Mr. Ibrahem/Wellens' syndrome

Wellens' syndrome is an electrocardiogram (ECG) pattern which often represents critical narrowing of the left anterior descending (LAD) coronary artery. People often have chest pain, which resolves by the time they arrive at the hospital. Complications include a 75% risk of myocardial infarction (MI) within weeks without appropriate treatment.

The underlying mechanism is believed to involve rupture of an atherosclerotic plaque leading to blockage of the LAD, followed by clot breakdown before a MI occurs. In about 90% of cases there is near blockage of the proximal LAD. It can also occur in coronary vasospasm and Takotsubo cardiomyopathy.

Diagnosis is based on an ECG showing deeply inverted or biphasic T waves in at least leads V2 and V3. Other findings may include ST-segment elevation of less than 1 mm, no Q waves, and normal or slightly increased troponin. When chest pain occurs, the ECG may appear normal.

Treatment is by percutaneous coronary intervention (PCI). Until this can be carried out, aspirin and heparin is typically used. Wellens' syndrome is relatively common. It was first described in 1982 by Hein Wellens.