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wellens syndrome

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...
March 31, 2017: European Heart Journal
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
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...
February 15, 2017: Cardiology
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...
February 9, 2017: Herzschrittmachertherapie & Elektrophysiologie
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...
December 24, 2016: American Journal of Emergency Medicine
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
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
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
Ruben Casado-Arroyo, Paola Berne, Jayakeerthi Yoganarasimha Rao, Moisés Rodriguez-Mañero, Moisés Levinstein, Giulio Conte, Juan Sieira, Mehdi Namdar, Danilo Ricciardi, Gian-Battista Chierchia, Carlo de Asmundis, Gudrun Pappaert, Mark La Meir, Francis Wellens, Josep Brugada, Pedro Brugada
BACKGROUND: A proband of Brugada syndrome (BrS) is the first patient diagnosed in a family. There are no data regarding this specific, high-risk population. OBJECTIVES: This study sought to investigate the Brugada probands diagnosed from 1986 through the next 28 years. METHODS: We included 447 probands belonging to families with a diagnostic type 1 electrocardiogram Brugada pattern. The database was divided into 2 periods: the first period identified patients who were part of the initial cohort that became the consensus document on BrS in 2002 (early group); the second period reflected patients first diagnosed from 2003 to January 2014 (latter group)...
August 9, 2016: Journal of the American College of Cardiology
Brian E Driver, Gautam R Shroff, Stephen W Smith
BACKGROUND: Reperfusion after coronary occlusion (myocardial infarction, MI), as in Wellens' syndrome, is often represented on ECG as T-wave inversion in the leads overlying the affected myocardial wall(s). As an extension of this logic, reperfusion of the posterior wall should manifest on right precordial leads (which are opposite the posterior wall) as enlarged T-waves. OBJECTIVE: We sought to determine whether T-wave amplitude (TWa) in leads V2 and V3 after reperfusion in posterior MI (PMI) is greater than in patients without PMI...
February 2017: Emergency Medicine Journal: EMJ
Hongcheng Mai, XianWu Lan, Dan Lu, Yusheng Zhang, AiDong Zhang, Tao Zhang
The case is a 52-year-old male admitted to cardiology department with chest tightness. Admission ECG showed nontypical T-wave changes in V2-V4 leads in pain peroids, and increasing severe narrowing of proximal LAD. Cardiac enzymes were abnormal. Emergency coronary angiography showed severe stenosis (99%) in proximal LAD.
June 2016: Clinical Case Reports
Farhan Ashraf
No abstract text is available yet for this article.
January 2017: Postgraduate Medical Journal
Deep Jaiswal, Dan Boudreau
No abstract text is available yet for this article.
2016: World Journal of Emergency Medicine
Eduardo Josué Flores Umanzor, Luca Vannini, Rodolfo San Antonio, Paula Sanchez Somonte, Victoria Martín-Yuste
No abstract text is available yet for this article.
March 2017: Internal and Emergency Medicine
Serdar Ozdemir, Tuba Cimilli Ozturk, Yalman Eyinc, Ozge Ecmel Onur, Muhammed Keskin
Wellens' Syndrome is a pattern of electrocardiographic T-wave changes associated with critical, proximal left anterior descending (LAD) artery stenosis. Diagnostic criteria of Wellens' Syndrome are history of chest pain, little or no cardiac enzyme elevation, little or no ST-segment elevation, no loss of precordial R waves, no pathologic precordial Q waves and typical T-wave changes. Urgent cardiac catheterization is vital to prevent myocardial necrosis. Here we are presenting two cases with Wellens' Syndrome who had been sent for catheterization before marked myocardial infarction developed...
December 2015: Turkish Journal of Emergency Medicine
Ali Attila Aydin, Kemal Türker Ulutas, Cemile Aydin, Murtaza Kaya, Umut Akar, Tayfun Ture
INTRODUCTION: Wellens Syndrome (WS) is a condition characterized by typical changes in ECG, which are biphasic T-wave inversions (less common) or symmetric and deeply inverted T waves (including 75%) in lead V2-V3 chest derivations. WS is considered important because it has not only diagnostic value but also prognostic value. CASE REPORT: A 52-year-old male patient without cardiovascular disease or risk factors was admitted to the emergency department (ED) suffering with chest pain and syncope, just after having been involved in a discussion at work...
February 2016: Acta Informatica Medica: AIM
Ivan Stankovic, Srdjan Kafedzic, Biljana Putnikovic, Aleksandar N Neskovic
No abstract text is available yet for this article.
December 29, 2015: Canadian Journal of Cardiology
Ghazala Irfan, Jens Czapla, Yukio Saitoh, Giuseppe Ciconte, Giacomo Mugnai, Giulio Conte, Burak Hunuk, Vedran Velagic, Erwin Stroker, Gian Battista Chierchia, Jan Nijs, Marc La Meir, Francis Wellens, Pedro Brugada, Carlo De Asmundis
AIM: The aim of our study is to compare two approaches of implantable cardiac defibrillator (ICD) implantation, conventional (supra/subpectoral) and subcostal in young adults in terms of procedural complications and adverse events encountered during follow-up. METHODS AND RESULTS: From January 2007 to December 2013, all patients under the age of 50 years who received an ICD in our centre were included in this study. Patient's hospital records were analysed for procedural complications and adverse events during follow-up until December 2014...
January 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Rohit Venkatesan, Nilubon Methachittiphan, Rafic F Berbarie, Emily Aaron, Zehra Jaffery, Umamahesh Rangasetty
No abstract text is available yet for this article.
February 2016: American Journal of Emergency Medicine
Juan Sieira, Giuseppe Ciconte, Giulio Conte, Gian-Battista Chierchia, Carlo de Asmundis, Giannis Baltogiannis, Giacomo Di Giovanni, Yukio Saitoh, Ghazala Irfan, Rubén Casado-Arroyo, Justo Julià, Mark La Meir, Francis Wellens, Kristel Wauters, Gudrun Pappaert, Pedro Brugada
BACKGROUND: Among Brugada syndrome patients, asymptomatic individuals are considered to be at the lowest risk. Nevertheless, arrhythmic events and sudden cardiac death are not negligible. Literature focused on this specific group of patients is sparse. The purpose of this study is to investigate the clinical characteristics, management, and long-term prognosis of asymptomatic Brugada syndrome patients. METHODS AND RESULTS: Patients presenting with spontaneous or drug-induced Brugada type I ECG and no symptoms at our institution were considered eligible...
October 2015: Circulation. Arrhythmia and Electrophysiology
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