Wellens Syndrome
OVERVIEW
- Wellens Syndrome = high grade LAD or LM coronary lesion
CRITERIA
- history of chest pain
- chest pain with a normal looking ECG (pseudonormalisation)
- minimally elevated cardiac enzymes
- no pathological precordial Q waves or loss of R wave progression
- pain free ST elevation in V2 and V3 (minimally elevated)
- pain free symmetrical deep T wave inversion or biphasic T waves in V2-V5
Two types
Type A – 25%
- pain free: biphasic T waves in the anterior leads
- during pain: paradoxical pseudonormalisation of ST segments
- needs to be recognized because it will cause anterior MI within 9 days (if not dealt to by PCI or CABG)
Type B – 75%
- deep symmetrical T wave inversion in I and aVL
- chest leads: 1mm of ST elevation
References and Links
- ECG Library – Wellens Syndrome
- Eponymictionary – Hein Wellens
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC