Exam
Wellen's Syndrome
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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 Wave
s abnormality in leads V2 and V3 (may involve all precordial leads)
Type A: Biphasic
T Wave
s, 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 Wave
s and preserved precordial
R Wave
s
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]
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