Wellens syndrome: a life-saving diagnosis

Am J Emerg Med. 2012 Jan;30(1):255.e3-5. doi: 10.1016/j.ajem.2010.10.014. Epub 2010 Nov 23.


The diagnosis of acute coronary syndrome relies on clinical history, electrocardiographic (ECG) changes, and cardiac biomarkers; but within the spectrum of acute coronary syndrome, there exist subtle presentations that cannot afford to be overlooked. Wellens syndrome is one such example, in which a patient can present with both ECG changes that are not classic for myocardial ischemia and negative cardiac biomarkers. The characteristic ECG findings associated with Wellens syndrome consist of deep, symmetric T-wave inversions in the anterior precordial leads. However, Wellens syndrome can also present as biphasic T-wave inversions in those same ECG leads. The associated critical stenosis of the proximal left anterior descending artery carries an immediately life-threatening prognosis if not recognized promptly (Am Heart J. 1982;103[4 Pt 2]:730-736). We describe a case of a less common manifestation of Wellens syndrome (type 1) followed by a discussion of its implications and management.

Publication types

  • Case Reports

MeSH terms

  • Chest Pain / etiology
  • Coronary Angiography
  • Coronary Stenosis / diagnosis*
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / physiopathology
  • Electrocardiography
  • Emergency Service, Hospital
  • Heart / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Syndrome