Wellens Syndrome
What is Wellens Syndrome?
This is a sign or occasionally warning that shows in an ECG occurring during periods of chest-pain free in individuals with angina that is unstable, signifying serious, proximal left anterior descending artery – LAD – stenosis.
Symptoms
Although looking healthy and normal, there are individuals in the world who naively have a hypothetically deadly cardiac disorder. These individuals are unmindful that they have a problem that can be lethal. This is also true of children with definite family types of failing ion channels of their heart cells.
Countless individuals die instantly from an arrhythmia that is deadly or fatal myocardial infarction.
There are divulging signs or symptoms that are noticeably evidence on their EKG or cardiac monitor that divulge these situations, long before substantial symptoms appear. These are lives that can be saved.
Often the cause of these arrhythmias that are deadly is a minute strip of conductive tissue only millimeters long. But, once discovered, a comparatively simple process can correct it forever.
Angina can have variable appearances, but classically these individuals will described the following:
- Chest pain designated as tightness, heaviness, or pressure
- Pain typically induced by activity, relieved with rest
- Pain that radiates to the shoulder, neck or jaw
May experience multiple associated symptoms, including:
- Diaphoresis
- Nausea
- Vomiting
- Fatigue
Occurs mostly in elderly, diabetic and female individuals are these individuals are more like to have these atypical symptoms.
Treatment
Since Wellens syndrome happens due to stenosis of the LAD, these individuals stereotypically present with chest pain as unstable angina. During pain episodes, they should be treated in the same manner as any individuals with chest pain thought to be cardiac in nature, which includes the following:
- Arrangements for transport immediately to the nearest hospital
- Attention to breathing, airway and circulation
- While transporting, efforts need to be made to do the following:
- Supplemental oxygen
- Vital signs
- Aspirin
- Intravenous access
- ECG, when available pre-hospital
- For persistent pain – nitroglycerin, morphine according to local protocols
Patients presenting with symptoms dependable with unstable angina should normally receive medications that may help elude a myocardial infarction. Typically, this would include the following:
- Intravenous access
- Supplemental oxygen
- Telemetry monitoring
- ECG
- Chest radiography
- Laboratory studies
- Care needs be given in providing aspirin, nitroglycerin, heparin, morphine, clopidogrel, beta-blocker therapy, and glycoprotein IIB/IIA inhibitors.
- ECG changes in Wellens syndrome are characteristically only existent when the individual is chest pain free.
Management
After the individual with Wellens syndrome is stable, a cardiac consultation needs to be obtained from a cardio-vascular surgeon. This condition can be corrected with a surgical procedure. In the meantime, the individual needs to be managed as listed above in order to avoid a myocardial infarction.
