What Is Wellens' Syndrome?

Wellens’ syndrome is essentially a pattern of electrocardiogram (ECG) waves that precedes a very serious stenosis of the proximal left anterior descending (LAD) artery within the heart. Generally, this pattern is observed in the T-wave portion of the ECG graph in patients with a history of angina not currently experiencing pain. The phenomenon was first observed by its namesake, Dr. Hein Wellens, who discovered it in 1982. Doctors and nurses should be familiar with the ECG pattern of Wellens’ syndrome, because it generally precedes a very serious incident that requires immediate medical attention. Case reports have also shown that the T-wave pattern can develop in patients who are experiencing pain at the time.

An ECG is a medical device which measures electronic signals on the surface of the skin that are produced by the heart. This is measured by ten leads which are attached to the patient’s chest and limbs, the results from which are displayed on a graph. Wellens’ syndrome is indicated by a fluctuation in what is referred to as the T-wave on the V2 to V5 leads attached to the patient. The T-wave is a short section following the QRS interval and the ST segment. The QRS interval is the largest variation in the ECG readout, and is easily identified by the sharp rise and fall in activity; the ST segment is usually a short horizontal section.

Patients who have recently had angina or other chest pain are at particular risk from Wellens’ syndrome, which is indicated by the T-wave dropping into the negative at a 60 to 90 degree angle. This drop in the readout often precedes a stenosis in the LAD artery. A stenosis is basically a narrowing of the artery to unusual and potentially dangerous levels. Any patients displaying early signs of Wellens’ Syndrome should be given surgery or other medical care as soon as possible.

Other wave patterns on ECG readouts can also be identified which are consistent with Wellens’ syndrome. For example, the Q wave, which usually precedes the large R wave, often disappears. This is coupled with a lack of change or possibly slight elevation in the ST portion of the wave. While these symptoms are usually indications of Wellens’ syndrome, they can occur without the consequent arterial narrowing. Other factors, such as the lack of pain prior to the condition, can also be different on some occasions.

Dr. Hein Wellens is the doctor primarily recognized for first identifying Wellens’ syndrome in 1982. He recognized the ECG pattern proceeding patient’s conditions getting worse. After some additional study on the affected patients, he discovered that the majority of them went on to suffer problems with the LAD artery.