Search

Wellens syndrome is characterised by negative or biphasic T waves in V2–V4 leads and critical stenosis of proximal part of the left descending coronary artery. These ECG changes without atherosclerotic changes in coronary angiography, i.e. coronary artery spasm are called pseudo-Wellens syndrome. We describe a patient with acute coronary syndrome and pseudo-Wellens syndrome as a cause of vasospastic angina. These ECG abnormalities need differentiation with acute pulmonary embolism.

A case of a 61-year-old patient with acute coronary syndrome (ACS) and minimal ECG changes is presented. The patient was admitted to a community hospital, where non-ST-segment elevation ACS was diagnosed. He was given standard pharmacotherapy and was transferred very early to an invasive facility, where coronarography and percutaneous coronary intervention of the large diagonal branch were performed. We stress the importance of non-invasive assessment with ECG and echocardiography, in addition to coronary angiography, for diagnosis and treatment decisions in complex cases.

We present a case of a 78-year-old female who was admitted to the hospital due to clinical and electrographic features of ST-elevation acute myocardial infarction. Coronary angiography revealed normal coronary arteries and severe left ventricular contractility abnormalities, detected initially by echocardiography, which resolved within 20 days from hospital admission. Because of these findings and typical echocardiographic picture, a transient left ventricular apical ballooning syndrome (the tako-tsubo syndrome) was diagnosed.