The “widow maker” warning sign or Wellens’ syndrome: A case report

Abstract

Wellens’ syndrome, also known as LAD (left anterior descending) coronary T-wave syndrome, “widow maker” or warning sign, is a potentially unrecognized critical proximal LAD stenosis with possible fatal consequences. It can be associated with extensive acute anterior wall myocardial infarction, with left ventricular dysfunction and a lethal outcome within a few days after the onset of symptoms. It usually consists of a typical ECG finding in the precordial leads that represents a significant proximal LAD stenosis in patients with unstable angina pectoris. Although this syndrome is not indicated for PCI (the patient is usually pain-free at the time of electrocardiography registration), it is necessary to recognize the characteristic pattern and perform an emergency coronary angiography and percutaneous or surgical revascularisation of the affected blood vessel. Here we present the case report of a 47 year-old woman without previous anamnesis of coronary disease. On admission to the Coronary Care Unit she was chest pain-free and had all the indicators of Wellens’ syndrome.

Keywords

• T-wave
• left anterior descending coronary artery (LAD)
• unstable angina pectoris
• stenosis
• ECG