Unmasking the Silent Danger: A Case Series of Wellens’ Syndrome and Its Implications for Early Intervention

Abstract

Wellens’ syndrome represents a critical Electrocardiographic (ECG) pattern indicative of severe proximal Left Anterior Descending (LAD) coronary artery stenosis, demanding urgent diagnosis and treatment. This case series details four patients with diverse clinical presentations and risk factors, all exhibiting Wellens’ syndrome. The cases illustrate both classic ECG features-biphasic or deeply inverted T waves in precordial leads-and atypical features, such as biphasic T-wave inversion extending to lateral leads and post-prandial chest pain in a patient with prior right coronary artery Percutaneous Coronary Intervention (PCI). This series underscores the need for clinicians to maintain a low threshold of suspicion for Wellens’ syndrome, even with atypical signs and low troponin levels. Each patient underwent coronary angiography revealing significant LAD stenosis, followed by successful PCI and secondary prevention strategies. These cases highlight the importance of recognising Wellens’ syndrome and the urgency of diagnosis and treatment to prevent major adverse cardiac events.

Keywords

• cardiac biomarkers
• left anterior descending artery stenosis
• myocardial infarction
• t wave inversion