In Wellens Syndrome, what are the EKG findings and the associated lesion?

In Wellens Syndrome, the characteristic electrocardiogram (EKG) findings include biphasic T waves or deeply inverted T waves, specifically in the precordial leads (V2 and V3). These changes are indicative of significant ischemia in the anterior part of the heart, which is primarily due to critical stenosis of the left anterior descending (LAD) artery.

The presence of these particular T wave changes suggests that the patient has a high risk of an acute myocardial infarction if not properly managed. The biphasic or deeply inverted T waves are considered a hallmark for Wellens Syndrome, signaling that despite potentially stable presentation, there is an urgent need for revascularization due to the underlying severe blockage of the coronary artery.

This connection between the specific EKG findings and the critical stenosis of the LAD is crucial for emergency medicine practitioners, as it underscores the importance of recognizing Wellens Syndrome in the context of chest pain assessment. Prompt identification can lead to timely intervention, significantly improving patient outcomes.