| 词条 | Wellens' syndrome | |||
| 释义 |
| name = Wellens' syndrome | synonyms = Wellens' sign, Wellens' warning, Wellens' waves | image = Wellens'_Syndrome.png | alt = | caption = EKG of a 69-year-old black male with Wellens' syndrome. Visible in leads V1-V4, here with a biphasic T-wave with negativisation. | pronounce = | field = Cardiology | width = 400px | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }}Wellens' syndrome is an electrocardiographic manifestation of critical proximal left anterior descending (LAD) coronary artery stenosis in patients with unstable angina. Originally thought of as two separate presentations, A and B, it is now considered an evolving wave form, initially of biphasic T w-wave inversions and later becoming symmetrical, often deep (>2 mm), T wave inversions in the anterior precordial leads.[1] First described by Hein J. J. Wellens and colleagues in 1982 in a subgroup of patients with unstable angina,[2] it does not seem to be rare, appearing in 18% of patients in his original study. A subsequent prospective study identified this syndrome in 14% of patients at presentation and 60% of patients within the first 24 hours.[3] The presence of Wellens' syndrome carries significant diagnostic and prognostic value. All patients in the De Zwann's study with characteristic findings had more than 50% stenosis of the left anterior descending artery (mean = 85% stenosis) with complete or near-complete occlusion in 59%. In the original Wellens' study group, 75% of those with the typical syndrome manifestations had an anterior myocardial infarction. Sensitivity and specificity for significant (more or equal to 70%) stenosis of the LAD artery was found to be 69% and 89%, respectively, with a positive predictive value of 86%.[4] Wellens' sign has also been seen as a rare presentation of Takotsubo cardiomyopathy or stress cardiomyopathy.{{Citation needed|date=March 2010}} Diagnostic criteria{{Prose|section|date=September 2014}}
References1. ^{{cite journal | last = Tandy | first = TK |author2=Bottomy DP |author3=Lewis JG | title = Wellens' syndrome | journal = Annals of Emergency Medicine | volume = 33 | issue = 3 | pages = 347–351 |date=March 1999 | pmid = 10036351 | doi = 10.1016/S0196-0644(99)70373-2}} 2. ^{{cite journal | last = de Zwaan | first = C |author2=Bär FW |author3=Wellens HJJ | title = Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction | journal = American Heart Journal | volume = 103 | issue = 4 | pages = 730–736 |date=April 1982 | pmid = 6121481 | doi = 10.1016/0002-8703(82)90480-X}} 3. ^{{cite journal | last = de Zwaan | first = C |author2=Bär FW |author3=Janssen JH | title = Angiographic and clinical characteristics of patients with unstable angina showing an ECG pattern indicating critical narrowing of the proximal LAD coronary artery | journal = American Heart Journal | volume = 117 | issue = 3 | pages = 657–665 |date=March 1989 | pmid = 2784024 | doi = 10.1016/0002-8703(89)90742-4|display-authors=etal}} 4. ^{{cite journal | last = Haines | first = DE |author2=Raabe DS |author3=Gundel WD |author4=Wackers FJ | title = Anatomic and prognostic significance of new T-wave inversion in unstable angina | journal = American Journal of Cardiology | volume = 52 | issue = 1 | pages = 14–18 |date=July 1983 | pmid = 6602539 | doi = 10.1016/0002-9149(83)90061-9}} External links{{Medical resources| DiseasesDB = | ICD10 = | ICD9 = | ICDO = | OMIM = | MedlinePlus = | MeSH = | GeneReviewsNBK = | GeneReviewsName = | Orphanet = }}{{Heart diseases}} 3 : Cardiac arrhythmia|Symptoms and signs: Circulatory system|Syndromes affecting the heart |
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