What is Wellens criteria?
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 is Wellens type A?
Two patterns of T waves can be seen in Wellens syndrome. Type-A T waves are biphasic, with initial positivity and terminal negativity. These T wave findings are present in approximately 25% of cases. Type-B T waves are deeply and symmetrically inverted.
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.
How is Wellens 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.
Is Wellens syndrome a STEMI?
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).
Who discovered Wellens syndrome?
Wellens syndrome was first described in the early 1980s by de Zwaan, Wellens, and colleagues, who identified a subset of patients with unstable angina who had specific precordial T-wave changes and subsequently developed a large anterior wall myocardial infarction (MI).
Is Wellens a Nstemi?
Symmetrically inverted or biphasic T waves in anterior precordial leads, Wellens’ sign, have been shown to represent impending infarction of left anterior descending (LAD) territory among unstable angina patients in the studies published more than 3 decades ago, when non-ST-segment elevation myocardial infarction ( …
How is triple vessel disease treated?
Coronary artery bypass graft (CABG) is the treatment of choice in patients of diabetes with triple vessel disease (TVD). If the patient has TVD but is asymptomatic, the dilemma is whether to continue with medical management or to opt for revascularization.
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.
Is Wellens syndrome rare?
Wellens’ syndrome is a rare entity that can also present with T-wave inversions. It comes in two flavors.
How serious is triple vessel disease?
Three-vessel disease (3VD) represents the most severe form of coronary atherosclerosis. Patients with 3VD and/or left main stenosis are considered a high-risk group according to therapeutic guidelines. In comparison with less severe forms of CAD, 3VD has been consistently associated with worse long-term prognosis.
How long can you live with triple vessel disease?
The basic characteristics of the group and its medication are shown in a table (Table 1). Approximately 50% of the patients with three-vessel disease died before the end of the study. The 5-year survival rate was 88%.
What is Wellens syndrome?
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)
What are the patterns of T-wave abnormality in Wellens syndrome?
There are two patterns of T-wave abnormality in Wellens syndrome: Type A – Biphasic, with initial positivity and terminal negativity (25% of cases) Type B – Deeply and symmetrically inverted (75% of cases) T wave changes can evolve over time from Type A to Type B pattern ( Smith et al ).
What is Wellens syndrome of v2-3?
Wellens syndrome is a pattern of deeply inverted or biphasic T waves in V2-3, which is highly specific for a critical stenosis of the left anterior descending artery (LAD).
What is the difference between Wellens syndrome and LVH?
The pattern of inverted and biphasic T waves is different to Wellens syndrome, affecting multiple leads (i.e. any lead with a tall R wave) rather than V2-3. In this case, the Wellens-like T waves are just a variant on the repolarisation abnormality ( LV “strain”pattern) that is seen with LVH.