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Wellen's Syndrome
Aka: Wellen's Syndrome, Wellens Syndrome
- See Also
- Electrocardiogram in Myocardial Infarction
- Acute Coronary Syndrome
- Acute Coronary Syndrome Immediate Management
- De Winter T Wave
- 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
- 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
- Interpretation
- Suggests critical left anterior descending artery
- High risk for significant anterior wall Myocardial Infarction in the coming days to weeks (regardless of symptoms)
- Resources
- Wellen's Syndrome (Life in the FastLane)
- http://lifeinthefastlane.com/ecg-library/wellens-syndrome/
- References
- Rhinehart (2002) Am J Emerg Med 20(7):638-43 +PMID:12442245 [PubMed]
- Tatli (2009) Cardiol J 16(1):73-5 +PMID:19130419 [PubMed]