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Variant of Wellen’s syndrome in type 1 diabetic patient: A case report

BACKGROUND: Wellen’s syndrome is a form of acute coronary syndrome associated with proximal left anterior descending artery (LAD) stenosis and characteristic electrocardiograph (ECG) patterns in pain free state. The abnormal ECG pattern is classified into type A (biphasic T waves) and type B (deeply...

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Autores principales: Obi, Mukosolu Florence, Sharma, Manjari, Namireddy, Vikhyath, Gargiulo, Paul, Noel, Chelsea, Hyun, Cho, Gale, Blossom De
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10600782/
https://www.ncbi.nlm.nih.gov/pubmed/37900265
http://dx.doi.org/10.4330/wjc.v15.i9.462
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author Obi, Mukosolu Florence
Sharma, Manjari
Namireddy, Vikhyath
Gargiulo, Paul
Noel, Chelsea
Hyun, Cho
Gale, Blossom De
author_facet Obi, Mukosolu Florence
Sharma, Manjari
Namireddy, Vikhyath
Gargiulo, Paul
Noel, Chelsea
Hyun, Cho
Gale, Blossom De
author_sort Obi, Mukosolu Florence
collection PubMed
description BACKGROUND: Wellen’s syndrome is a form of acute coronary syndrome associated with proximal left anterior descending artery (LAD) stenosis and characteristic electrocardiograph (ECG) patterns in pain free state. The abnormal ECG pattern is classified into type A (biphasic T waves) and type B (deeply inverted T waves), based on the T wave pattern seen in the pericodial chest leads. CASE SUMMARY: We present the case of a 37-year-old male with history of type 1 diabetes mellitus (T1DM), gastroparesis, mild peripheral artery disease and right toe cellulitis on IV antibiotics who presented to the emergency department with nausea, vomiting and abdominal pain for 3 d and as a result couldn’t take his insulin. Noted to have fasting blood sugar 392 mg/dL. Admitted for diabetic gastroparesis. During the hospital course, the patient was asymptomatic and denied any chest pain. On admission, No ECG and troponin draws were performed. On day 2, the patient became hypoxic with oxygen saturation 80% on room air, intermittent mild right-sided chest pain which he attributed to vomiting from his gastroparesis. Initial ECG done was significant for Biphasic T wave changes in leads V2 and V3 and elevated high sensitivity troponin. Patient was transitioned to cardiac intensive care unit and cardiac catheterization performed with result significant for extensive coronary artery disease. CONCLUSION: This case highlights an exceptional manifestation of Wellen's syndrome, wherein the right coronary artery and circumflex artery display a remarkable 100% constriction, alongside a proximal LAD stenosis of 90%-95%. Notably, this occurrence transpired in a patient grappling with extensive complications arising from T1DM. Moreover, it underscores the utmost significance of promptly recognizing the presence of Wellen's syndrome and swiftly initiating appropriate medical intervention.
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spelling pubmed-106007822023-10-27 Variant of Wellen’s syndrome in type 1 diabetic patient: A case report Obi, Mukosolu Florence Sharma, Manjari Namireddy, Vikhyath Gargiulo, Paul Noel, Chelsea Hyun, Cho Gale, Blossom De World J Cardiol Case Report BACKGROUND: Wellen’s syndrome is a form of acute coronary syndrome associated with proximal left anterior descending artery (LAD) stenosis and characteristic electrocardiograph (ECG) patterns in pain free state. The abnormal ECG pattern is classified into type A (biphasic T waves) and type B (deeply inverted T waves), based on the T wave pattern seen in the pericodial chest leads. CASE SUMMARY: We present the case of a 37-year-old male with history of type 1 diabetes mellitus (T1DM), gastroparesis, mild peripheral artery disease and right toe cellulitis on IV antibiotics who presented to the emergency department with nausea, vomiting and abdominal pain for 3 d and as a result couldn’t take his insulin. Noted to have fasting blood sugar 392 mg/dL. Admitted for diabetic gastroparesis. During the hospital course, the patient was asymptomatic and denied any chest pain. On admission, No ECG and troponin draws were performed. On day 2, the patient became hypoxic with oxygen saturation 80% on room air, intermittent mild right-sided chest pain which he attributed to vomiting from his gastroparesis. Initial ECG done was significant for Biphasic T wave changes in leads V2 and V3 and elevated high sensitivity troponin. Patient was transitioned to cardiac intensive care unit and cardiac catheterization performed with result significant for extensive coronary artery disease. CONCLUSION: This case highlights an exceptional manifestation of Wellen's syndrome, wherein the right coronary artery and circumflex artery display a remarkable 100% constriction, alongside a proximal LAD stenosis of 90%-95%. Notably, this occurrence transpired in a patient grappling with extensive complications arising from T1DM. Moreover, it underscores the utmost significance of promptly recognizing the presence of Wellen's syndrome and swiftly initiating appropriate medical intervention. Baishideng Publishing Group Inc 2023-09-26 2023-09-26 /pmc/articles/PMC10600782/ /pubmed/37900265 http://dx.doi.org/10.4330/wjc.v15.i9.462 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
Obi, Mukosolu Florence
Sharma, Manjari
Namireddy, Vikhyath
Gargiulo, Paul
Noel, Chelsea
Hyun, Cho
Gale, Blossom De
Variant of Wellen’s syndrome in type 1 diabetic patient: A case report
title Variant of Wellen’s syndrome in type 1 diabetic patient: A case report
title_full Variant of Wellen’s syndrome in type 1 diabetic patient: A case report
title_fullStr Variant of Wellen’s syndrome in type 1 diabetic patient: A case report
title_full_unstemmed Variant of Wellen’s syndrome in type 1 diabetic patient: A case report
title_short Variant of Wellen’s syndrome in type 1 diabetic patient: A case report
title_sort variant of wellen’s syndrome in type 1 diabetic patient: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10600782/
https://www.ncbi.nlm.nih.gov/pubmed/37900265
http://dx.doi.org/10.4330/wjc.v15.i9.462
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