Wellens' Syndrome and Myocardial Infarction Detection
Summary
Wellens’ syndrome is a pre-infarction clinical entity characterised by distinctive electrocardiographic T-wave abnormalities that herald critical stenosis of the proximal left anterior descending (LAD) artery. Recognised during pain-free intervals, these biphasic or deeply inverted T waves in leads V2–V3 reflect transient anterior wall ischaemia and predict impending anterior myocardial infarction if left untreated. Early detection on a standard electrocardiogram (ECG) enables prompt catheter-based intervention, notably percutaneous coronary intervention (PCI), to avert extensive myocardial necrosis. Advances in imaging and clinical algorithms have refined the sensitivity of detecting subtle Wellens patterns, while improved risk stratification has optimised timing of invasive management. In parallel, the classification of acute coronary syndromes, including non-ST-segment elevation myocardial infarction (NSTEMI), integrates biomarker assessment with nuanced ECG interpretation, enhancing the precision of infarction detection and patient outcomes worldwide.
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Wellens' Syndrome and Myocardial Infarction Detection publication trend
The graph below shows the total number of articles in wellens' syndrome and myocardial infarction detection across all publications each year (not limited to Nature Index journals).
Technical terms
Wellens’ syndrome: A characteristic ECG pattern of biphasic or deeply inverted T waves in leads V2–V3 indicating critical proximal LAD stenosis and impending anterior myocardial infarction.
Electrocardiogram (ECG): A recording of the heart’s electrical activity used to detect ischaemic changes and arrhythmias.
Left anterior descending artery (LAD): The coronary vessel supplying the anterior wall of the left ventricle, often implicated in anterior wall ischaemia and infarction.
Biphasic T wave: A T wave with an initial upward deflection followed by a downward deflection, often signalling transient ischaemia.
Deep T-wave inversion: Profound negative T-wave deflections suggestive of myocardial ischaemia or injury.
Percutaneous coronary intervention (PCI): A catheter-based procedure to dilate stenotic coronary arteries and deploy stents to restore blood flow.
Non-ST-segment elevation myocardial infarction (NSTEMI): A type of myocardial infarction without persistent ST-segment elevation on the ECG, reflecting partial coronary artery occlusion.
References
- Wellens Syndrome: prevalence, risk factors and coronary angiographic variation. A cross-sectional study. BMC Cardiovascular Disorders (2024).
- The Comparative Assessment of Wellens’ Syndrome With Proximal Left Anterior Descending Artery (LAD) Stenosis Versus Right Coronary Artery (RCA) or Circumflex Coronary Artery Stenosis and Its Prevalence: A Systematic Review. Cureus (2023).
- Characteristics of Wellens’ Syndrome in the Current PCI Era: A Single‐Center Retrospective Study. Emergency Medicine International (2023).
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