Wellens' syndrome: Difference between revisions
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#Biphasic T waves in leads V2-V3 OR symmetric, often deeply inverted T waves in V2-V3 | #Biphasic T waves in leads V2-V3 OR symmetric, often deeply inverted T waves in V2-V3 | ||
#Prior history of chest pain | #Prior history of chest pain (CP resolved) | ||
#Little or no cardiac enzyme elevation | #Little or no cardiac enzyme elevation | ||
#No pathologic precordial Q waves | #No pathologic precordial Q waves | ||
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#No loss of precordial R waves | #No loss of precordial R waves | ||
*A: Biphasic pattern | Two T-wave Characteristics: | ||
*B: Inversion pattern | |||
*A: Biphasic pattern - 75% - Deeply inverted and symmetric T-waves | |||
*B: Inversion pattern - 25% - Biphasic T-waves (initial + deflection and terminal - deflection) | |||
[[Image:Wellens.jpg]] | [[Image:Wellens.jpg]] | ||
Revision as of 22:34, 12 January 2014
Background
- T wave abnormality that is associated with critical LAD stenosis
- Finding can be transient (persists for hours after pain has resolved and then disappears)
- Preinfarction stage of CAD, and heralds extensive anterior wall MI
Criteria
- Biphasic T waves in leads V2-V3 OR symmetric, often deeply inverted T waves in V2-V3
- Prior history of chest pain (CP resolved)
- Little or no cardiac enzyme elevation
- No pathologic precordial Q waves
- Little or no ST-segment elevation
- No loss of precordial R waves
Two T-wave Characteristics:
- A: Biphasic pattern - 75% - Deeply inverted and symmetric T-waves
- B: Inversion pattern - 25% - Biphasic T-waves (initial + deflection and terminal - deflection)
Note Wellens criteria should not be diagnosed in a patetient with LVH.
Treatment
- Urgent cardiac catheterization
Source
Wellens’ Syndrome. Annals of Emergency Medicine, March, 1999