Wellen's Syndrome: Is One Electrocardiogram Good and Plenty?

Autor: Schears MR; Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA., Sleigh BC; Emergency Medicine, Mercer University College of Medicine, Macon, USA., Ganti L; Emergency Medicine, University of Central Florida College of Medicine / Hospital Corporation of America Graduate Medical Education (HCA GME) Consortium, Kissimmee, USA.
Jazyk: angličtina
Zdroj: Cureus [Cureus] 2019 Apr 05; Vol. 11 (4), pp. e4394. Date of Electronic Publication: 2019 Apr 05.
DOI: 10.7759/cureus.4394
Abstrakt: The authors present a case of Wellen's syndrome, which has a characteristic T-wave on an electrocardiogram during a pain-free period in a patient with intermittent chest pain. The clinical presentation, pathophysiology, and management is discussed, and the importance of obtaining more than one electrocardiogram (ECG) is explained.  What this case adds to the literature is the fact that Wellen's syndrome patients may present atypically with active chest pain and, as such, should be managed similarly to acute myocardial infarction patients. However, because the diagnosis of Wellen's syndrome depends on an ECG obtained during the ensuing pain-free period, serial ECGs are usually required to reveal T-wave abnormalities in this context and have been shown to be disposition-altering in the Emergency Department (ED). Support for the death-denying outcome preferred in Wellen's syndrome by patients and providers alike depends on recognizing the diagnosis and consulting cardiology expediently.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE