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Unique electrocardiographic findings are rarely observed in acute coronary syndrome (ACS) with a culprit left anterior coronary artery (LAD). The aim of this study was to assess the epidemiological features and prognostic impact. This study was designed as an observational study. A total of 641 patients with a culprit lesion in the left main trunk or LAD were extracted from a cohort of 1776 ACS patients. The primary endpoint was mortality, comparing patients presenting with unique electrocardiogram patterns, specifically the de Winter pattern or Wellens' syndrome (type A or B), upon hospital arrival, with those presenting common electrocardiogram patterns. A unique electrocardiogram was observed in 7.0% (n = 45; 2 with de Winter pattern, 14 with Wellens' type A and 29 with type B). Compared to patients with a common pattern, cardiogenic shock at hospital arrival were rare in patients with a unique pattern (0% vs. 8.4%, P = 0.04), and percutaneous coronary intervention was primary revascularization strategy in all groups (95.6% vs. 98.2%). The mortality rates were similar between the two groups over a median 565 days of observation period (13.3% vs. 15.7%, P = 0.43), with 0% in Wellens' type A, 13.8% in type B, and both patients with the de Winter pattern died. The de Winter pattern or the Wellens syndrome was found in 7.0% of cases with ACS. They had similar mortality rates compared to those with a common pattern, although the de Winter pattern was identified in only 2 patients. • A unique ECG (de Winter pattern or Wellens' syndrome) is observed in 7.0% of ACSs. • They have a lower critical severity and no early death. • Their mortality rates are equivalent to patients with a common pattern. • However, the de Winter pattern is very rare and has a high mortality. [ABSTRACT FROM AUTHOR]

One of the most common form of cardiac abnormality is Myocardial Infarction (heart attack) arises when the artery connecting the heart is blocked and there is no sufficient blood or oxygen, which makes the cells present in that region of the heart to die. This paper aims to process and classify an ECG signal as healthy subject or subject diagnosed with Myocardial Infarction (MI) using Artificial Neural Networks (ANN) and SVM (Support Vector Machine). LIBSVM 1 is utilized for the classification with SVM and backpropogation artificial neural networks with varying hidden layers and nodes are also implemented for performance analysis. [ABSTRACT FROM AUTHOR]

Background: The Wellens'' electrocardiogram (ECG) pattern of dynamic T-wave inversion in the anterior leads is observed in clinical conditions characterized by reversible left ventricular (LV) dysfunction (stunned myocardium), either ischemic or nonischemic. The pathophysiologic basis of this ECG pattern remains to be elucidated. Objective: The purpose of this study was to report the contrast-enhanced cardiac magnetic resonance (CE-CMR) findings in 4 cases of Wellens'' ECG pattern associated with transient LV dysfunction from a variety of clinical conditions such as myocardial bridge, coronary artery dissection, cholecystitis, and takotsubo syndrome. Methods: All patients underwent CE-CMR at the time of acute clinical manifestations and after 6 to 8 weeks of follow-up to assess the presence and dynamics of LV myocardial changes. Results: In all patients, the Wellens'' ECG abnormalities were associated with increased signal intensity of the LV myocardium on T2-weighted sequences suggesting myocardial edema, in the absence of late enhancement on postcontrast sequences. Repolarization abnormalities and myocardial edema had a parallel time course with persistence beyond recovery of mechanical abnormalities. T-wave inversion was associated with transient prolongation of the QTc interval in all cases. Conclusion: The study results suggest that myocardial edema rather than systolic dysfunction underlies the Wellens'' ECG pattern, regardless of the causative mechanism. [Copyright &y& Elsevier]

Negative T waves in electrocardiography have been widely studied. We presents a case of Wellens' syndrome which is a pattern of global inverted T waves with QT prolongation on ECG due to transient proximal LAD occlusion and pointed out other differential diagnosis. [ABSTRACT FROM AUTHOR]