Early Diagnosis and Prompt Treatment of Severe Stenosis in The Proximal Left Anterior Descending Coronary Artery (Wellens’ Syndrome)
DOI:
https://doi.org/10.55175/cdk.v46i1.534Keywords:
LAD artery, T wave, Wellens’ syndromeAbstract
The electrocardiography misinterpretation occurs in 20-40% of misdiagnosed myocardial infarction cases. Wellens' syndrome is a typical T-wave finding that shows severe stenosis in the proximal of left anterior descending (LAD) artery, leading to extensive anterior myocardial infarction within days. Cardiac stress tests should not be performed in this condition. Prognosis is fair when identified early and proper coronary intervention was immediately performed.
Kesalahan interpretasi elektrokardiografi terjadi pada 20-40% kasus infark miokard yang salah terdiagnosis. Sindrom Wellens merupakan temuan gelombang-T khas yang menunjukkan stenosis berat di arteri turun anterior kiri (LAD) proksimal, dapat menyebabkan infark miokard anterior luas dalam beberapa hari. Tes stres jantung tidak boleh dilakukan dalam kondisi ini. Kebanyakan pasien dapat membaik jika teridentifikasi dini dan intervensi koroner yang tepat segera dilakukan.
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References
Vedanthan R, Seligman B, Fuster V. Global perspective on acute coronary syndrome. Circulation Res. 2014;114;1959-75
Appel-da-Silva MC, Zago G, Abelin AP, Dutra OP, Vaz R, Pin WO. Sindrome de Wellens. Arquivos Brasileiros de Cardiologia. 2010;94(4):54-6
Tewelde SZ, Mattu A, Brady WJ. Pitfalls in electrocardiographic diagnosis of acute coronary syndrome in low risk chest pain. Western J Emergency Med. 2017;18(4):601-6
Unluer EE, Pinar A, Bozdemir H, Bayata S, Unluer S, Yavasi O. Red flags in electrocardiogram for emergency physicians: remembering wellens’ syndrome and upright T wave in V1. Western J Emergency Med. 2012;13(2):160-3
Ozdemir S, Cimilli Ozturk T, Eyinc Y, Onur OE, Keskin M. Wellens’s syndrome report of two cases. Turkish J Emergency Med. 2015;15:179-81
Htut et al. Omnious T-wave inversions: Wellens’ syndrome revisited. J Comm Hospital Intern Med Perspectives. 2016;6(32011):1-4
Aehlert B. Basic electrophysiology. ECGs Made Easy. 6thed: Elsevier; 2018
Aro AL, Anttonen O, Tikkanen JT, Junttila MJ, Kerola T, Rissanen HA, et al. Prevalence and prognostic significance of T-wave inversion in right precordial leads of a 12-lead electrocardiogram in the middle-aged subjects. Circulation. 2012;125:2572-7
Said SAM, Bloo R, de Nooijer R, Slootweg A. Cardiac and non-cardiac causes of T-wave inversion in the precordial leads in adult subjects: A Dutch case series and review of the literature. World J Cardiol. 2015;7(2):94
Sowers N. Wellens syndrome electrocardiographic abnormalities in the emergency department. Can Fam Physician. 2013;59:1-2
Grautoff S. Wellens’ syndrome can indicate high-grade LAD stenosis in case of left bundle branch block. Herzschrittmacherter Elektrophysiol. 2017;28(1):57-9.
Das D, Almajed NS. Wellens syndrome. CMAJ. 2016;188(7)
Hatopo AB, Hariawan H, Taufiq N. The dynamic electrocardiogram pattern of T wave inversion following ST segment elevation in acute coronary syndrome with non significant coronary artery disease. Acta Cardiol Indon. 2016;2(2):99
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