Intermittent Typical Angina: Remember Wellens’ Syndrome

  • Marco Nastasi Division of Cardiology, University of Catania, Catania, Italy
Keywords: Case Reports, Chest Pain, Coronary Angiography, Electrocardiography, 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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References

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Published
2019-06-09
How to Cite
Nastasi, M. (2019). Intermittent Typical Angina: Remember Wellens’ Syndrome. Advanced Journal of Emergency Medicine, 3(3), e30. https://doi.org/10.22114/ajem.v0i0.155
Section
Case (report / study)