Vignette says a 50 year old male presents to the emergency department with an episode of chest pain induced by excretion 1 hour back, currently he doesn't complain of chest pain; He has a history of hypertension for which he takes amlodipine; Vital signs show blood pressure of 130/80 mm of Hg, pulse rate of 88 bpm, respiratory rate of 18 breaths/min, oxygen saturation of 98% in RA and temperature of 96.9 F; ECG shows biphasic T wave in lead V2; Cardiac biomarkers (i.e. troponins) are normal; Diagnosis?
Diagnosis is a type A wellens syndrome.
Wellens syndrome is characterized by biphasic T waves or deeply inverted T waves in leads V2-V3, that is highly specific for critical stenosis of the proximal left anterior descending coronary artery, usually pain free at presentation to the emergency department with normal or mild elevated cardiac biomarkers; Require immediate percutaneous coronary intervention (PCI) to relive the occlusion.
Figure:- ECG showing biphasic T wave in lead V2 suggestive of type A wellens syndrome.
No comments:
Post a Comment