What is Wellen syndrome?

Wellens syndrome describes a pattern of electrocardiographic (ECG) changes, particularly deeply inverted or biphasic T waves in leads V2-V3, that is highly specific for critical, proximal stenosis of the left anterior descending (LAD) coronary artery. It is alternatively known as anterior, descending, T-wave syndrome.

How is Wellens syndrome diagnosed?

The criteria used to diagnose Wellen’s syndrome include symmetric and deeply inverted T waves or biphasic T waves in leads V2 and V3 in a pain-free state, plus isoelectric or minimally elevated (<1 mm) ST segment.

What are Wellens waves?

Wellens Syndrome is a clinical syndrome characterised by biphasic or deeply inverted T waves in V2-3, plus a history of recent chest pain now resolved. It is highly specific for critical stenosis of the left anterior descending artery (LAD) Wellens pattern A: Biphasic T waves. Wellens pattern B: Deeply inverted T waves.

How is Wellen syndrome treated?

Patients with Wellens syndrome are to be treated as unstable angina. This includes aspirin, nitroglycerin, and pain control, if needed. Patients should be admitted to the hospital where serial cardiac markers and electrocardiograms should be followed.

How is Brugada diagnosed?

The main test for Brugada syndrome is as an electrocardiogram (ECG). It checks the heart’s electrical activity and is usually done in hospital. During an ECG, small sensors are attached to your arms, legs and chest.

Is Brugada syndrome serious?

Overview. Brugada (brew-GAH-dah) syndrome is a rare but potentially life-threatening heart rhythm condition (arrhythmia) that is sometimes inherited. People with Brugada syndrome have an increased risk of irregular heart rhythms beginning in the lower chambers of the heart (ventricles).

Is Wellens a STEMI equivalent?

When we say STEMI or STEMI-equivalent, the image of a fully occluded coronary artery that requires immediate PCI comes to mind. Wellens syndrome is not really a “STEMI” but more of a post-STEMI or a pre-STEMI (along with being a non-STEMI).

What is Wellens Type B?

There are two ECG patterns in Wellens’ syndrome: Type A is characterized by deeply symmetrical T-wave inversions in leads V2 and V3, often including leads V1 and V4 and occasionally leads V5 and V6; type B is characterized by biphasic T-waves in leads V2 and V3.

Is ACS a Wellens syndrome?

As a well-known high-risk ACS, Wellens’ syndrome, first described by de Zwaan and Wellens in 1982 [4], is the characteristic ST-T segment change in the precordial leads, indicating a critical stenosis high in the left anterior descending arterial (LAD).

When should you suspect posterior MI?

ST elevation in the posterior leads of a posterior ECG (leads V7-V9). Suspicion for a posterior MI must remain high, especially if inferior ST segment elevation is also present. ST segment elevation in the inferior leads (II, III and aVF) if an inferior MI is also present.

What are the symptoms of Brugada?

Signs and symptoms that may be associated with Brugada syndrome include:

  • Dizziness.
  • Fainting.
  • Gasping and labored breathing, particularly at night.
  • Irregular heartbeats or palpitations.
  • Extremely fast and chaotic heartbeat.
  • Seizures.