Intermittent Typical Angina: Remember Wellens’ Syndrome
Author(s):
Message:
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.
Article Type:
Case Report
Language:
English
Published:
Advanced Journal of Emergency Medicine, Volume:3 Issue:3, 2019
Page:
10
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