Wellens Syndrome (left anterior descending coronary T wave syndrome) describes a group of clinical and electrocardiographic changes seen with arteriosclerosis of the left anterior descending artery (LAD).


Synonym: acute coronary T-wave syndrome



(1) critical high-grade stenosis in the proximal left anterior descending (LAD) artery

(2) history of unstable angina (acute coronary syndrome with little or no elevation of serum markers for acute myocardial infarction)

(3) ECG changes - one of the following:

(3a) plus-minus T waves with inversion of the terminal portion in the LAD coronary artery territory (V1 to V5 or V6) = Wellens Warning

(3b) symmetrical, deeply negative and broad-based T waves

ECG Type

ECG Features

Type 1

plus-minus T wave with inversion of the terminal portions in leads V2 through V6

Type 2

deep symmetrical T wave inversion, especially in V2 and V3


A patient with Wellen syndrome will typically progress to an acute anterior wall myocardial infarction. The patient should not have a stress test, but rather should undergo emergent cardiac catheterization.


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