What is the Wellens syndrome in unstable angina?

Updated: Oct 01, 2020
  • Author: Walter Tan, MD, MS; Chief Editor: Eric H Yang, MD  more...
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Wellens syndrome refers to specific ECG abnormalities in the precordial T-wave segment, which are associated with critical stenosis of the proximal LAD coronary artery. De Zwaan, Wellens, and colleagues in the early 1980s recognized this subset of patients with unstable angina who had specific precordial T-wave inversions and subsequently developed a large anterior wall MY. [35] Wellens syndrome is also referred to as LAD coronary T-wave syndrome. [36] Syndrome criteria include the following:

  • Characteristic T-wave changes

  • A history of anginal chest pain

  • Normal or minimally elevated cardiac enzyme levels

  • An ECG without Q waves, without significant ST elevation, and with normal precordial R-wave progression

Recognition of this ECG abnormality is of paramount importance because LAD coronary T-wave syndrome represents a preinfarction stage of CAD that often progresses to a devastating anterior wall infarction.

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