II. Criteria
- Anterior T Waves abnormality in leads V2 and V3 (may involve all precordial leads)
- Type A: Biphasic T Waves, initially positive and then negative (25% of cases)
- Type B: Deep T Wave Inversion (50% of cases)
- ST segment may be normal or <1 mm of ST Elevation
- No precordial Q Waves and preserved precordial R Waves
- Associated with recent Angina, but EKG performed when pain free
- Cardiac enzymes normal or minimally elevated
III. Differential Diagnosis
- See T Wave
- Pulmonary Embolism
- Right Bundle Branch Block
- Left Bundle Branch Block
- Hypertrophic Cardiomyopathy
- Normal variant (e.g. children)
- Brugada Syndrome
- Hypokalemia
IV. Interpretation
- Suggests critical left anterior descending artery
- High risk for significant anterior wall Myocardial Infarction in the coming days to weeks (regardless of symptoms)
V. Resources
- Wellen's Syndrome (Life in the FastLane)
