Published Online : 2025-12-30
Wellens syndrome is a distinct electrocardiographic (ECG) finding that reflects critical narrowing of the proximal left anterior descending (LAD) coronary artery. First identified in 1982, this pattern typically appears in patients with a history of unstable angina, especially during pain-free intervals. Recognizing this syndrome is vital, as it signals a high risk for imminent anterior wall myocardial infarction if not treated promptly. The syndrome is classified into two types based on T wave morphology. Type A, which features biphasic T waves most prominently in leads
V2 and V3, can be particularly challenging to identify. These subtle ECG changes are often overlooked, especially when the patient is not actively experiencing chest pain, which increases the risk of misdiagnosis or delayed treatment. Such oversight can lead to rapid deterioration and serious cardiac complications, including extensive myocardial infarction. In this case report, we present a patient with type A Wellens syndrome, where the early ECG showed only mild biphasic T wave abnormalities that were initially missed. This diagnostic oversight delayed appropriate cardiologic intervention and emphasized the importance of vigilance in evaluating atypical or transient ECG changes. Early identification of Wellens syndrome, even in asymptomatic phases, is critical to guiding appropriate management and preventing life-threatening outcomes. Clinicians, particularly in
emergency medicine settings, should be aware of these subtle yet significant ECG markers.
Case Report
English
P. 227-231
