Atypical Presentation of Acute Coronary Syndrome and Importance of Wellens’ Syndrome

Autor: Sammy San Myint Aung, Htwe Htwe Yin, Nay Min Tun, Wut-Yi Phoo, Htun Latt, Kyaw Kyaw
Rok vydání: 2018
Předmět:
medicine.medical_specialty
Acute coronary syndrome
medicine.medical_treatment
Diagnostic Techniques
Cardiovascular
Wellens' syndrome
030204 cardiovascular system & hematology
Coronary Angiography
Chest pain
Risk Assessment
Severity of Illness Index
Diagnosis
Differential
Electrocardiography
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Facial Pain
Angioplasty
Internal medicine
medicine
Humans
Acute Coronary Syndrome
Angioplasty
Balloon
Coronary
Aged
Neck pain
Neck Pain
business.industry
Coronary Stenosis
Percutaneous coronary intervention
Stent
Drug-Eluting Stents
030208 emergency & critical care medicine
Articles
Syndrome
General Medicine
medicine.disease
Stenosis
Treatment Outcome
Asymptomatic Diseases
Cardiology
Female
medicine.symptom
Emergency Service
Hospital
business
Zdroj: The American Journal of Case Reports
ISSN: 1941-5923
Popis: Patient: Female, 74 Final Diagnosis: Acute coronary syndrome Symptoms: Throat pain Medication: — Clinical Procedure: Percutaneous coronary intervention Specialty: Cardiology Objective: Challenging differential diagnosis Background: Acute coronary syndrome (ACS) is a common and potentially life-threatening condition encountered in emergency departments. Despite its dreaded nature, nearly one-third of ACS present without chest pain and may mislead clinicians. Additionally, Wellens’ syndrome is a pre-infarction stage of significant proximal left anterior descending (LAD) artery stenosis, which can lead to extensive anterior wall myocardial infarction without timely intervention. Case Report: We report the case of a 74-year-old woman presenting with isolated throat pain and Wellens’ pattern in the initial EKG, which prompted the proper workup and management. Subsequently, coronary angiogram revealed more than 90% occlusion of the proximal LAD artery, and a drug-eluting stent was deployed. The patient did well after the procedure and the follow-up at 2 weeks after discharge was uneventful. Conclusions: This case highlights the importance of awareness of atypical presentation of ACS and importance of Wellens’ syndrome. We also discuss the incidence of craniofacial symptoms of ACS, and the epidemiology, pathophysiology, management, and prognosis of Wellens’ syndrome.
Databáze: OpenAIRE
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