Which lab studies are indicated in the workup of Wellens syndrome?

Updated: Jan 25, 2018
  • Author: Benjamin B Mattingly, MD; Chief Editor: Erik D Schraga, MD  more...
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Answer

The following laboratory studies may be indicated as adjunctive tests in patients with suspected coronary artery disease (CAD), acute coronary syndrome (ACS), and Wellens syndrome:

  • Complete blood count (CBC) - To ensure that anemia is not precipitating the angina, red blood cell (RBC) transfusions may be necessary

  • Basic metabolic profile - This includes electrolyte, blood urea nitrogen (BUN), creatinine, and glucose levels

  • Typing and screening - These are indicated if immediate cardiac catheterization is planned

  • D-dimer, international normalized ratio (INR), partial thromboplastin time (PTT) - These are ordered only as medically necessary

  • Cardiac biomarkers - In Wellens syndrome, cardiac biomarkers can be falsely reassuring, in that they are typically normal or only minimally elevated; only 12% of patients with this syndrome have elevated cardiac biomarker levels, and these are always less than twice the upper limit of normal, in the absence of myocardial infarction (MI) [5]


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