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wellens syndrome

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https://www.readbyqxmd.com/read/29661666/pseudo-wellens-syndrome-and-intermittent-left-bundle-branch-block-in-a-case-of-acute-cholecystitis
#1
Steffen Grautoff, Martin Balog, Guenther Winde
We present a case of a 54-year-old male patient who was admitted to our Emergency Department (ED) with localized epigastric pain. Inflammation markers, ultrasound, and CT scan were inconsistent with an initial diagnosis of cholecystitis. However, there was additional evidence of cholecystolithiasis. The ECG showed new anterior biphasic T waves typical for a Wellens' type A ECG. Additionally, the patient had an intermittent left bundle branch block (LBBB). The diagnostic challenges in differentiating possible diagnoses will be described, to which in this case, were either acute cholecystitis or acute coronary syndrome (ACS)...
April 7, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29543374/long-term-outcome-and-quality-of-life-in-patients-with-total-colonic-aganglionosis-in-the-netherlands
#2
D Roorda, M J Witvliet, L M Wellens, D V Schulten, C E J Sloots, I de Blaauw, P M A Broens, J Oosterlaan, L W E van Heurn, A F W van der Steeg
AIM: Total colonic aganglionosis (TCA) is a severe form of Hirschsprung's Disease (HD) associated with a high morbidity. This study assesses long-term functional outcome and Quality of Life (QoL) of TCA patients in a national consecutive cohort. METHODS: Medical records of all patients (n=53) diagnosed between 1995 and 2015 were reviewed on surgical and demographic characteristics. Functional outcome of all non-syndromal patients, aged ≥ four years (n=35) was assessed in medical records and with a questionnaire...
March 15, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29467360/atypical-presentation-of-acute-coronary-syndrome-and-importance-of-wellens-syndrome
#3
Kyaw Kyaw, Htun Latt, Sammy San Myint Aung, Nay Min Tun, Wut-Yi Phoo, Htwe Htwe Yin
BACKGROUND Acute coronary syndrome (ACS) is a common and potentially life-threatening condition encountered in emergency departments. Despite its dreaded nature, nearly one-third of ACS present without chest pain and may mislead clinicians. Additionally, Wellens' syndrome is a pre-infarction stage of significant proximal left anterior descending (LAD) artery stenosis, which can lead to extensive anterior wall myocardial infarction without timely intervention.  CASE REPORT We report the case of a 74-year-old woman presenting with isolated throat pain and Wellens' pattern in the initial EKG, which prompted the proper workup and management...
February 22, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29246935/cocaine-induced-pseudo-wellens-syndrome-a-wellens-phenocopy
#4
Aung Naing Lin, Sithu Lin, Rahul Gokhroo, Deepika Misra
Wellens' syndrome represents critical occlusion of the proximal left anterior descending coronary artery. Electrocardiographic changes similar to Wellens' wave are not exceptional to acute coronary occlusion and can also be seen in cardiac and non-cardiac conditions, such as left ventricular hypertrophy, persistent juvenile T wave, bundle branch blocks, cerebral haemorrhage, pulmonary oedema, pulmonary embolism, pheochromocytoma, Takotsubo syndrome, digitalis and cocaine-induced coronary vasospasm. Cocaine-induced pseudo-Wellens' syndrome should be considered as one of the differentials, since cocaine is used frequently by young adults and can cause left anterior descending coronary vasospasm mimicking Wellens' syndrome...
December 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28966546/tic-treatment-goes-tech-a-review-of-tichelper-com
#5
Christine A Conelea, Brianna C M Wellen
TicHelper.com ("TicHelper") is an interactive online treatment program for youth with chronic tic disorders (CTDs) or Tourette Syndrome (TS) and their parents. It is based on Comprehensive Behavioral Intervention for Tics (CBIT), an individual, outpatient therapy protocol shown to effectively reduce tics in randomized controlled trials. The TicHelper website offers a user-friendly dashboard that is effective in making it easy to navigate through different treatment modules. Modules parallel core CBIT procedures and consist of interactive exercises, informational videos, and self-report ratings...
August 2017: Cognitive and Behavioral Practice
https://www.readbyqxmd.com/read/28844661/-wellen-s-syndrome-much-more-than-a-t-wave
#6
Jonathan Cardona-Vélez, Laura Ceballos-Naranjo, Sneider Torres-Soto
No abstract text is available yet for this article.
January 2018: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28806166/pseudo-wellens-syndrome-after-heavy-marijuana-use
#7
Michael Lawrenz Ferreras Co, Anshuman Das, Tochukwu Okwuosa
No abstract text is available yet for this article.
August 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28801134/wellens-syndrome
#8
A Rosales-Castillo, J Plaza-Carrera
No abstract text is available yet for this article.
August 8, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28757781/type-b-wellens-syndrome-electrocardiogram-patterns-that-clinicians-should-be-aware-of
#9
Yin-Chou Hsu, Chih-Wei Hsu, Tien-Chang Chen
No abstract text is available yet for this article.
April 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28614245/wellens-syndrome-in-hiv-infected-patients-two-case-reports
#10
Bowei Tan, Carlos Morales-Mangual, Dan Zhao, Abdullah Khan, Hal Chadow
BACKGROUND: Wellens syndrome is a pattern of electrocardiographic (ECG) changes in the context of unstable angina characterized with deep inverted T-waves or biphasic T-waves in the precordial leads. These specific ECG changes are highly suggestive of stenosis in the left anterior descending artery (LAD), which can result in acute myocardial infarction, left ventricular dysfunction, or death. Human immunodeficiency virus (HIV) infection is known as an independent risk factor for the cardiovascular disease...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28551719/t-wave-changes-in-patients-with-wellens-syndrome-are-associated-with-increased-myocardial-mechanical-and-electrical-dispersion
#11
COMPARATIVE STUDY
Ivan Stankovic, Srdjan Kafedzic, Aleksandra Janicijevic, Radosava Cvjetan, Tijana Vulovic, Milica Jankovic, Ivan Ilic, Biljana Putnikovic, Aleksandar N Neskovic
Some patients with unstable angina and critical stenosis of the left anterior descending coronary artery (LAD) present with Wellens syndrome (WS), i.e., inverted or biphasic T-waves in the anterior precordial leads. We assessed clinical, angiographic, electro- and echocardiographic characteristic of patients with WS. In this retrospective study, clinical, angiographic, electro- and echocardiographic characteristic of 35 patients with WS were compared to 57 patients with critical LAD stenosis and normal resting electrocardiogram (ECG), and 45 subjects with normal coronary angiogram...
October 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28479512/long-term-prognosis-of-drug-induced-brugada-syndrome
#12
Juan Sieira, Giuseppe Ciconte, Giulio Conte, Carlo de Asmundis, Gian-Battista Chierchia, Giannis Baltogiannis, Giacomo Di Giovanni, Yukio Saitoh, Ruben Casado-Arroyo, Justo Juliá, Mark La Meir, Francis Wellens, Kristel Wauters, Gudrun Pappaert, Pedro Brugada
BACKGROUND: Patients with drug-induced Brugada syndrome (BS) are considered at a lower risk than those with a spontaneous type I pattern. Nevertheless, they can present arrhythmic events. OBJECTIVE: The purpose of this study was to investigate their clinical characteristics, long-term prognosis and risk factors. METHODS: A consecutive cohort of 343 patients with drug-induced BS was included and compared with 78 patients with a spontaneous type I pattern...
October 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28379344/a-score-model-to-predict-risk-of-events-in-patients-with-brugada-syndrome
#13
Juan Sieira, Giulio Conte, Giuseppe Ciconte, Gian-Battista Chierchia, Ruben Casado-Arroyo, Giannis Baltogiannis, Giacomo Di Giovanni, Yukio Saitoh, Justo Juliá, Giacomo Mugnai, Mark La Meir, Francis Wellens, Jens Czapla, Gudrun Pappaert, Carlo de Asmundis, Pedro Brugada
Aims: Risk stratification in Brugada Syndrome (BS) remains challenging. Arrhythmic events can occur life-long and studies with long follow-ups are sparse. The aim of our study was to investigate long-term prognosis and risk stratification of BS patients. Methods and results: A single centre consecutive cohort of 400 BS patients was included and analysed. Mean age was 41.1 years, 78 patients (19.5%) had a spontaneous type I electrocardiogram (ECG). Clinical presentation was aborted sudden cardiac death (SCD) in 20 patients (5...
June 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28341793/bet-1-in-patients-with-suspected-acute-coronary-syndrome-does-wellens-sign-on-the-electrocardiograph-identify-critical-left-anterior-descending-artery-stenosis
#14
REVIEW
Niall Morris, Laura Howard
Wellens' syndrome consists of a history suggestive of an acute coronary syndrome and biphasic or deeply inverted T waves in ECG leads V2-V3. A shortcut review was carried out to establish whether this ECG pattern identifies patients with a critical left anterior descending artery stenosis. Six relevant papers were found. The clinical bottom line is that biphasic T-wave inversion in lead V2-V3 should alert the clinician to a probable critical stenosis of the left anterior descending artery.
April 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28196358/wellens-syndrome-a-bad-omen
#15
Madalena Coutinho Cruz, Isabel Luiz, Lurdes Ferreira, Rui Cruz Ferreira
Wellens' syndrome is characterized by an electrocardiographic pattern of T-wave changes associated with a critical stenosis of the left anterior descending artery (LAD), which progresses to an extensive anterior myocardial infarction in the majority of cases. For this reason, its recognition and early treatment are extremely important. We report 2 cases of Wellens' syndrome: an 83-year-old male presenting with ill-characterized chest pain, biphasic T waves in V1-V3 during an asymptomatic period, negative cardiac biomarkers, and a 64% stenosis in LAD with a fractional flow reserve of 0...
2017: Cardiology
https://www.readbyqxmd.com/read/28185080/wellens-syndrome-can-indicate-high-grade-lad-stenosis-in-case-of-left-bundle-branch-block
#16
Steffen Grautoff
Diagnosing acute myocardial infarction (AMI) in left bundle branch block (LBBB) is challenging. Modified Sgarbossa criteria are known to help detect AMI in LBBB. This is a report about an electrocardiogram (ECG) with Wellens' signs in combination with a pre-existing LBBB. The ECG of a patient with fluctuating chest pain showed very subtle and one day later more obvious Wellens'signs. A left anterior descending artery (LAD) stenosis was diagnosed and successfully treated. Wellens' syndrome can be diagnosed in a case of LBBB and help detect a high-grade LAD stenosis even if modified Sgarbossa criteria are not met...
March 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28089241/dynamic-t-wave-inversions-in-the-setting-of-left-bundle-branch-block
#17
H Pendell Meyers, Stephen W Smith
We illustrate the case a patient with left bundle branch block (LBBB) and electrocardiogram (ECG) changes consistent with those described in Wellens' syndrome. The characteristic ECG findings of Wellens' syndrome identify patients who have a particularly high rate of important coronary events in the near future, however these findings have previously been described only in the setting of normal conduction. A review of Wellens' syndrome, its criteria and pathophysiology, and its proposed appearance in the setting of LBBB is presented...
June 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27951539/wellens-syndrome-with-syncope-but-not-chest-pain
#18
Omar Z Yasin, Alberto Rubio-Tapia, Maurice E Sarano
We report the case of a woman in her 70s presenting to the emergency department with syncope, troponemia, and an electrocardiogram with deep symmetric T-wave inversions in V2 and V3 and prolonged QTc. Her presentation was concerning for acute coronary syndrome, Wellens syndrome in particular, given the elevated troponin levels, lack of ST segment changes, and characteristic T-wave findings. The diagnosis was confirmed with angiography that showed a critical left anterior descending (LAD) artery occlusion. Since myocardial infarction does not typically present with syncope, we explored the differential diagnoses for T-wave inversions, which include electrolyte abnormalities, medications, intracranial hemorrhage, pulmonary embolism, and other cardiac diseases that were ruled out in our patient...
2017: Cardiology
https://www.readbyqxmd.com/read/27609724/omnious-t-wave-inversions-wellens-syndrome-revisited
#19
Swe Zin Mar Win Htut Oo, Koroush Khalighi, Archana Kodali, Cho May, Thein Tun Aung, Richard Snyder
Wellens' syndrome is characterized by T-wave changes in electrocardiogram (EKG) during pain-free period in a patient with intermittent angina chest pain. It carries significant diagnostic and prognostic value because this syndrome represents a pre-infarction stage of coronary artery disease involving proximal left anterior descending (LAD) artery, which can subsequently lead to extensive anterior myocardial infarctions (MIs) and even death without coronary angioplasty. Therefore, it is crucial for every physician to recognize EKG features of Wellens' syndrome in order to take appropriate immediate intervention to reduce mortality and morbidity for MI...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27553695/a-warning-sign
#20
Sandeep Patri, Soji Joseph, Yashwant Agrawal
A 64year old man presented with atypical chest pain of 6h duration. Physical examination showed tachycardia and an irregularly irregular pulse. Initial EKG showed atrial fibrillation with rapid ventricular rate. Intravenous Diltiazem was administered following which there was resolution of atrial fibrillation as well as his chest pain. Troponin T and CPK-MB were minimally elevated at 0.05ng/ml (0.0-0.03ng/ml) and 8.6ng/ml (0.0-7.0ng/ml) respectively. A repeat EKG obtained after symptom resolution showed biphasic T wave inversions in V2 and V3 which prompted an emergent coronary angiogram that revealed 90% occlusion of the proximal LAD...
March 2017: European Journal of Internal Medicine
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