Intermittent Typical Angina: Remember Wellens’ Syndrome

Abstract

Introduction: We describe a patient without a history of cardiovascular diseases as an example of Wellens’ syndrome (WS). Case Report: A 65-year-old man presented to emergency department due to intermittent chest pain. Physical examination and chest x-ray were unremarkable. Electrocardiogram (ECG) showed biphasic T-wave in precordial leads V1-V4. Primary cardiac serum biomarkers including high-sensitive cardiac troponin T (hs-cTnT) and CK-MB were slightly elevated, that further assessment did not show any increases; while ECG recorded during a pain period revealed T-wave pseudo-normalization. The patient underwent coronary angiography that revealed a proximal left anterior descending artery lesion. Conclusion: WS is a diagnostic and management challenge and serial ECG evaluation is still essential for a possible acute coronary syndrome. Having knowledge of all subtle features of this syndrome, could avoid improper discharge of high-risk patients. Definitely, accurate risk stratification, and prompting these patients to an early coronary angiogram and treatment are mandatory to avoid development of a massive anterior myocardial infarction.

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Files
IssueVol 3 No 3 (2019): Summer (July) QRcode
SectionCase (report / study)
Keywords
Case Reports Chest Pain Coronary Angiography Electrocardiography Wellens’ Syndrome

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How to Cite
1.
Nastasi M. Intermittent Typical Angina: Remember Wellens’ Syndrome. Front Emerg Med. 2019;3(3):e30.

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