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A Pathognomonic Electrocardiogram That Requires Urgent Percutaneous Intervention: A Case of Wellens Syndrome in a Previously Healthy 55-Year-Old Male

Patient: Male, 55 Final Diagnosis: Wellens’ syndrome Symptoms: Chest pain Medication: — Clinical Procedure: — Specialty: Cardiology OBJECTIVE: Rare disease BACKGROUND: Acute chest pain is a common presentation in emergency departments worldwide. Ruling out acute coronary syndrome is essential in ens...

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Autores principales: Singh, Dilpreet, Suliman, Idrees, Chyshkevych, Iryna, Dabage, Nemer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364456/
https://www.ncbi.nlm.nih.gov/pubmed/30686820
http://dx.doi.org/10.12659/AJCR.912056
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author Singh, Dilpreet
Suliman, Idrees
Chyshkevych, Iryna
Dabage, Nemer
author_facet Singh, Dilpreet
Suliman, Idrees
Chyshkevych, Iryna
Dabage, Nemer
author_sort Singh, Dilpreet
collection PubMed
description Patient: Male, 55 Final Diagnosis: Wellens’ syndrome Symptoms: Chest pain Medication: — Clinical Procedure: — Specialty: Cardiology OBJECTIVE: Rare disease BACKGROUND: Acute chest pain is a common presentation in emergency departments worldwide. Ruling out acute coronary syndrome is essential in ensuring patient safety. Workup includes electrocardiogram (ECG) and cardiac biomarkers. Wellens syndrome is characterized by a history of chest pain, normal or minimally elevated biomarkers, no STEMI/Q-waves, and specific ECG changes. These changes consist of biphasic T waves in lead V2 and V3 or deep symmetrically inverted T waves in leads V1–V4. CASE REPORT: A 55-year-old male presented to the emergency department with acute chest pain in a background of active smoking, hypertension, and hyperlipidemia. His ECG was characteristic of Wellens syndrome type 1 and negative cardiac biomarkers. His TIMI (thrombolysis in myocardial infarction) score was 2, however, he failed conservative management necessitating urgent coronary angiogram. Critical stenosis of the proximal left anterior descending (LAD) coronary artery was found which required 2 drug eluting stents. He was discharged home asymptomatic on optimal medical therapy. CONCLUSIONS: Conventional management of patients with NSTEMI (non-ST-elevation myocardial infarction) and unstable angina with risk stratification utilizing TIMI score may not be appropriate in patient with Wellens syndrome. This highlights the importance of ECG recognition and urgent percutaneous intervention in patients with Wellens syndrome. Failure to identify this clinical syndrome could result in significant morbidity and mortality because it relates to critical stenosis and imminent large myocardial infarction.
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spelling pubmed-63644562019-02-15 A Pathognomonic Electrocardiogram That Requires Urgent Percutaneous Intervention: A Case of Wellens Syndrome in a Previously Healthy 55-Year-Old Male Singh, Dilpreet Suliman, Idrees Chyshkevych, Iryna Dabage, Nemer Am J Case Rep Articles Patient: Male, 55 Final Diagnosis: Wellens’ syndrome Symptoms: Chest pain Medication: — Clinical Procedure: — Specialty: Cardiology OBJECTIVE: Rare disease BACKGROUND: Acute chest pain is a common presentation in emergency departments worldwide. Ruling out acute coronary syndrome is essential in ensuring patient safety. Workup includes electrocardiogram (ECG) and cardiac biomarkers. Wellens syndrome is characterized by a history of chest pain, normal or minimally elevated biomarkers, no STEMI/Q-waves, and specific ECG changes. These changes consist of biphasic T waves in lead V2 and V3 or deep symmetrically inverted T waves in leads V1–V4. CASE REPORT: A 55-year-old male presented to the emergency department with acute chest pain in a background of active smoking, hypertension, and hyperlipidemia. His ECG was characteristic of Wellens syndrome type 1 and negative cardiac biomarkers. His TIMI (thrombolysis in myocardial infarction) score was 2, however, he failed conservative management necessitating urgent coronary angiogram. Critical stenosis of the proximal left anterior descending (LAD) coronary artery was found which required 2 drug eluting stents. He was discharged home asymptomatic on optimal medical therapy. CONCLUSIONS: Conventional management of patients with NSTEMI (non-ST-elevation myocardial infarction) and unstable angina with risk stratification utilizing TIMI score may not be appropriate in patient with Wellens syndrome. This highlights the importance of ECG recognition and urgent percutaneous intervention in patients with Wellens syndrome. Failure to identify this clinical syndrome could result in significant morbidity and mortality because it relates to critical stenosis and imminent large myocardial infarction. International Scientific Literature, Inc. 2019-01-28 /pmc/articles/PMC6364456/ /pubmed/30686820 http://dx.doi.org/10.12659/AJCR.912056 Text en © Am J Case Rep, 2019 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Singh, Dilpreet
Suliman, Idrees
Chyshkevych, Iryna
Dabage, Nemer
A Pathognomonic Electrocardiogram That Requires Urgent Percutaneous Intervention: A Case of Wellens Syndrome in a Previously Healthy 55-Year-Old Male
title A Pathognomonic Electrocardiogram That Requires Urgent Percutaneous Intervention: A Case of Wellens Syndrome in a Previously Healthy 55-Year-Old Male
title_full A Pathognomonic Electrocardiogram That Requires Urgent Percutaneous Intervention: A Case of Wellens Syndrome in a Previously Healthy 55-Year-Old Male
title_fullStr A Pathognomonic Electrocardiogram That Requires Urgent Percutaneous Intervention: A Case of Wellens Syndrome in a Previously Healthy 55-Year-Old Male
title_full_unstemmed A Pathognomonic Electrocardiogram That Requires Urgent Percutaneous Intervention: A Case of Wellens Syndrome in a Previously Healthy 55-Year-Old Male
title_short A Pathognomonic Electrocardiogram That Requires Urgent Percutaneous Intervention: A Case of Wellens Syndrome in a Previously Healthy 55-Year-Old Male
title_sort pathognomonic electrocardiogram that requires urgent percutaneous intervention: a case of wellens syndrome in a previously healthy 55-year-old male
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364456/
https://www.ncbi.nlm.nih.gov/pubmed/30686820
http://dx.doi.org/10.12659/AJCR.912056
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