An Overview on Wellens Syndrome

Abstract

Wellens syndrome is a pre-infarction stage of critical stenosis in the proximal left anterior descending (LAD) coronary artery, first described in the early 1980s. It is characterized by specific electrocardiographic (ECG) patterns in patients who are often pain-free at the time of presentation. These patterns include deeply inverted or biphasic T waves in the anterior precordial leads (V2–V3), with little or no elevation of cardiac enzymes. Despite the absence of acute ST-segment elevation, the syndrome signifies a very high risk of imminent large anterior wall myocardial infarction if left untreated. Recognition of Wellens syndrome is clinically important because patients may appear stable, but inappropriate management—such as stress testing—can precipitate acute myocardial infarction or sudden cardiac death. Early identification on ECG, combined with urgent coronary angiography and revascularization, can be lifesaving.