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Patient
67-year-old woman, smoker, non insulin-dependent diabetic, hospitalized for episodes of repeated chest pains since several days; ECG recorded in the absence of pain;
Trace
Sinus rhythm, normal PR interval; presence of a narrow Q-wave in leads III and aVF; isoelectric ST-segment; biphasic T-wave (positive/negative) in V2, V3, V4; this is a pattern of Wellens’ syndrome type 1;
Patient
75-year-old woman, NIDD, hospitalized for repeated chest pain; ECG recorded in absence of pain;
Trace
Sinus rhythm, normal PR interval; isoelectric ST-segment; negative and symmetrical T-wave in V1, V2, V3, V4; this is a pattern of Wellens’ syndrome type 2;
Exergue
It is important to recognize a Wellens’ syndrome on the electrocardiogram (negative or biphasic T-waves in V2, V3 in absence of pain, without ST-segment elevation) in order to propose aggressive management and avoid the occurrence of anterior infarction by complete occlusion of the proximal LAD.
These two patients had an electrocardiogram compatible with Wellens’ syndrome. In both cases, coronary angiography showed a proximal LAD lesion (sub-occlusion for the first patient, severe stenosis for the second).