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Wellens syndrome, also known as LAD coronary Twave syndrome, is a pattern of electrocardiographic (ECG) changes that are indicative of critical proximal left anterior descending (LAD) coronary artery stenosis. It was first described by Dr. Hein J.J. Wellens and his colleagues in the early 1980s. Wellens syndrome is important to recognize because it indicates a highrisk lesion that could lead to a large anterior wall myocardial infarction (heart attack) if left untreated.

The characteristic ECG findings in Wellens syndrome include deeply inverted or biphasic Twaves in the precordial leads (V2V6) during painfree periods, often referred to as "Wellens waves." These Twave abnormalities typically occur after an episode of angina and can persist for hours to days. The patient may have little to no symptoms at the time of the ECG, which makes these findings particularly significant.

Patients with Wellens syndrome are often found to have a significant stenosis in the proximal LAD artery, which supplies a large portion of the heart muscle. This critical narrowing of the artery can lead to myocardial infarction (heart attack) if not promptly treated with revascularization procedures such as angioplasty and stenting or coronary artery bypass grafting (CABG).

It's crucial for healthcare professionals, particularly those working in emergency departments or cardiology settings, to be aware of the characteristic ECG findings of Wellens syndrome. Identifying these patterns can prompt timely intervention, which can significantly improve the patient's prognosis and reduce the risk of a major heart attack. Patients with suspected Wellens syndrome should be managed in consultation with a cardiologist and may require urgent coronary angiography and revascularization.


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