Wednesday, August 24, 2022

Wellens pattern

Q: What is "Wellens pattern" on EKG?

Answer: The "Wellens pattern" is also known as LAD-T-wave inversion pattern. As the name implies, it is marked by deep T-wave inversions in multiple precordial leads, mostly V1 to V4. Despite signs of severe ischemia, there may not be any cardiac enzyme elevations or any ST elevations. 

This signifies high-grade stenosis in the Left Anterior Descending (LAD) coronary artery. It can be life-threatening.

#cardiology



References:

1. Rhinehardt J, Brady WJ, Perron AD, Mattu A. Electrocardiographic manifestations of Wellens' syndrome. Am J Emerg Med 2002; 20:638.

2. Haines DE, Raabe DS, Gundel WD, Wackers FJ. Anatomic and prognostic significance of new T-wave inversion in unstable angina. Am J Cardiol 1983; 52:14.

3. de Zwaan C, Bär FW, Janssen JH, et al. Angiographic and clinical characteristics of patients with unstable angina showing an ECG pattern indicating critical narrowing of the proximal LAD coronary artery. Am Heart J 1989; 117:657.

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