Wellens Pattern: Same ECG Curve, Different Pathways

韦伦斯模式:相同的ECG曲线,不同的传导通路

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Abstract

INTRODUCTION: Wellens syndrome refers to a characteristic electrocardiographic pattern, marked by inverted or biphasic T waves in leads V(2) and V(3), associated with a critical proximal stenosis of the left anterior descending artery. Patients with Wellens syndrome typically present asymptomatically and with normal or slightly elevated troponin levels. This condition is frequently under-recognized, leading to delays in diagnosis and treatment. CASE SUMMARY: We report 4 clinical cases, 3 women and 1 man, with a mean age of 64 years and no prior cardiac history. All patients initially presented with a clinical picture of unstable angina or non-ST-segment elevation myocardial infarction, with a characteristic Wellens pattern on electrocardiogram. In 2 patients, the pattern was promptly recognized, however in the other 2 cases, the diagnosis was initially missed, resulting in delayed intervention. CONCLUSIONS: Our case series show how promptly recognition and timely action can lead to better prognosis in terms of myocardial injury and left ventricular ejection fraction.

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