Wellens' Syndrome Presenting as Epigastric Pain and Syncope: An Unusual Presentation

Authors

Temitope Ajibawo
Alexander Andreev
Sonu Sahni, Touro CollegeFollow

Document Type

Article

Publication Date

2-4-2020

Publication Title

Cureus

DOI

10.7759/cureus.6877

Abstract

Wellens' syndrome, also regarded as left anterior descending coronary T-wave syndrome, is an electrocardiography (EKG) pattern that indicates critical proximal left anterior descending artery (LAD) stenosis. It is characterized by deeply inverted T-waves or biphasic T-waves in the anterior precordial chest leads in a patient with unstable angina. Patients typically present with symptoms consistent with acute coronary syndrome. We present a unique case of Wellens' syndrome with no angiographic findings of significant stenosis in the proximal LAD but with significant occlusion of the proximal circumflex artery and initial presentation with a chief complaint of epigastric pain and syncope. Physicians need to recognize these characteristic EKG changes during the pre-infarction stage, as they represent myocardial necrosis. Many of these patients eventually develop extensive anterior myocardial infarction with marked left ventricular dysfunction and death if coronary angiography and coronary revascularization are not performed within a few weeks. If Wellens' is seen, patients should undergo urgent cardiac catheterization.

Comments

Originally published in Cureus. See https://doi.org/10.7759/cureus.6877

Recommended Citation

Ajibawo, T., Andreev, A., & Sahni, S. (2020). Wellens' Syndrome Presenting as Epigastric Pain and Syncope: An Unusual Presentation. Cureus, 12 (2), 6877. https://doi.org/10.7759/cureus.6877

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.