Wellens Syndrome

Ischaemia

Recognition

  • Biphasic (type A) or deeply inverted (type B) T waves in V2–V3
  • During pain-free interval after episode of chest pain
  • No Q waves, preserved R waves

Key findings

  • Critical proximal LAD stenosis
  • Troponin often only mildly elevated

Clinical importance

  • High risk of extensive anterior MI within days if untreated

Management pearls

  • Admit + DAPT + heparin
  • Angiography — do NOT stress-test (may precipitate MI)
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WardRound

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