- 期刊
Wellens' Syndrome: A Case Report
Wellens氏症候群：一病例報告
摘要
Wellens氏症候群為冠狀動脈左前下降支的嚴重狹窄及進展成左心室前壁心肌梗塞，其臨床症狀不顯著但具有特殊的心電圖變化。在Wellens氏症候群中心電圖的胸部導程的特徵為雙相性T波以及對稱倒深T波，特別是在V2及V3導極上。我們這次報告的Wellens氏症候群個案，是於急診室中觀察到象徵性的ST-T波段心電圖改變，並且由冠狀動脈血管攝影顯示證實左前下降支冠狀動脈有嚴重狹窄。急診醫師應該了解Wellens氏症候群心電圖ST-T波段之特徵，利用此線索來早期診斷Wellens氏症候群。
並列摘要
Wellens' syndrome is associated with significant stenosis of the proximal left anterior descending coronary artery and a high risk for anterior wall myocardial infarction. Wellens' syndrome has subtle clinical symptoms and a characteristic electrocardiographic (ECG) presentation. The characteristic ECG pattern of Wellens' syndrome includes biphasic T waves or deeply inverted T waves in the precordial leads, especially in leads V2 and V3. We herein present a case of Wellens' syndrome with the characteristic ST-T segment changes during symptom-free observation in the emergency department, at which time the critical stenosis in the proximal part of the left anterior descending artery was demonstrated by coronary angiography. Because patients often respond well to the initial therapy, the severity of the disease is easily neglected. Therefore it is important for emergency physicians to use these clues and a series of ECG studies to identify Wellens' syndrome.