What is the pathophysiology of Wellens syndrome?

Updated: Jan 25, 2018
  • Author: Benjamin B Mattingly, MD; Chief Editor: Erik D Schraga, MD  more...
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Wellens syndrome represents critical stenosis of the proximal LAD artery. The LAD arises from the left coronary artery and travels in the interventricular groove along the anterior portion of the heart to the apex. This groove is situated between the right and left ventricles of the heart. The LAD gives rise to 2 main branches, the diagonals and the septal perforators. [4]

A lesion in the proximal LAD can have severe consequences, as suggested by the common nickname given to this lesion: “widow maker.” The LAD supplies the anterior wall of the heart, including both ventricles, as well as the septum. An occlusion in this vessel can result in serious ventricular dysfunction, thus placing the patient at serious risk for congestive heart failure (CHF) and death.

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