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Wellen's syndrome


  • deep, prominent T wave inversion or biphasic T waves in leads V2-4 in the presence of persistent R waves
  • probably represents transient STEMI due to occlusion of the LAD that, before the ECG, spontaneously opened or received collateral flow.
  • this is associated with a high incidence of critical narrowing of the proximal LAD and thus high risk for reocclusion with recurrent STEMI and potential for sudden death.
  • these patients should be referred to cardiology urgently for angiography - stress testing may cause sudden death!

inferior Wellen's syndrome

  • a similar scenario may occur with a very tight right coronary artery
  • the ECG shows upward bowing of the ST segments of the inferior leads with symmetrically inverted T waves
  • perhaps consider this next time you are looking for that S1 QIII TIII pattern of a PE
ecg_wellens_synd.txt · Last modified: 2020/05/23 14:02 by wh