Advanced

Uncommon LAD Coronary T-Wave Inversion : Wellens’ Syndrome : A Case Report

Author : M.R. Felani, M.N. Adhitya, S. Revan, M.F. Yusuf, M.W. Hadi, S. Khairunnisa, M.N. Afif, S.F. Liliana
Upload Date : 19-04-2018

Introduction: Wellens' Syndrome is characterized by an electrocardiographic (ECG) pattern of T-wave changes associated with critical stenosis of left anterior descending (LAD) artery. Urgent cardiac catheterization is vital to prevent further myocardial injury. We are presenting an uncommon case of Wellens' Syndrome, which the patient had been sent for cardiac catheterization before myocardial infarction did develop.

Case Description: A 40-year-old male admitted to emergency room with transient squeezing left chest pain since two weeks ago, deep and symmetrical T-waves inversion in V1-V6 (with very subtle ST Elevation in V1-V4 and normal Q waves), normal cardiac troponin, and normal left ventricular ejection fraction (70% of LVEF). He was given an acute coronary syndrome protocol, and escorted to cardiac cath lab soon for coronary angiography. He had a 90% stenosis in mid-LAD, and was submitted to percutaneous coronary intervention.

Discussion: The spectrum of Wellens' syndrome is very wide, and  high clinical suspicion for its diagnosis, especially in its rarest presentation of precordial ECG finding (Type B of Wellens’s Syndrome in this case), is an important role to avoid terrible consequences. With coronary intervention as a definitive management of the case, the improvements obtained with normalization of patient’s precordial ECG finding, and all of his clinical symptoms had fully relieved.

Conclusion: It is very important for general physicians to recognize the typical ECG findings of Wellens' Syndrome, because it is considered as a specific marker for critical LAD occlusion and high risk for incoming anterior wall myocardial injury. There will be significant morbidity and mortality that can occur without urgent coronary revascularization.

KEYWORDS : Wellens’ syndrome, myocardial injury, coronary intervention


Save Item
Download
Similar Articles

The Predictors of No Reflow Phenomenon after Percutaneous Coronary Intervention in Patients with ST Elevation Myocardial Infarction: A Meta-Analysis(Mohammad Saifur Rohman)

Effect of Percutaneous Coronary Intervention on Length Of Stay in Late Onset (>12 hours) STEMI Patients with High Degree AV Block.(D. D. A. Sakti, D. Firman, S. Dharma)

Comparison of Interleukin-6 Post Percutaneous Coronary Intervention between Patients with Acute Myocardial Infarction that Underwent Complete and Incomplete Revascularization(P. K. Dewi, S. Rifqi, N. Anggriyani, N. Wijayahadi)

The Efficacy of Levosimendan Infusion on Hemodynamic Improvement in Patient Cardiogenic Shock (CS) after Percutaneous Coronary Intervention (PCI) or Intraaortic Balloon Pump (IABP) : a Mini Systematic Review(M. D. Jalma, W. Rahmadhani, J. M. Siahaan)

Profile Patient with ST-Elevation Myocardial Infarction Underwent Percutaneous Coronary Intervention at Kariadi Hospital(Y.S. Pratama, S. Sungkar, A. Yudanto, S. Rifqi)

Early Diagnosis and Prompt Treatment of Severe Stenosis in The Proximal Left Anterior Descending Coronary Artery: Wellens’ Syndrome Case Report(H. R. S. Dhilion, Haikal, B. Pamungkas, A. Harsoyo, V. Pratama)

Successful Percutaneus Revascularization of Total Occlusion of the Ostial Left Main Coronary Artery: A Rare Case Report(D. Wardana, N.A. Tafriend, U. Bahrudin, Y. Herry)

Definite Sub Acute Stent Thrombosis after Primary Percutaneous Coronary Intervention(G.Aditya, W. Aryadana)

Copyrights © 2018 ASMIHA | Managed by Indonesia Medical Event (IME)