Abstract

OBJECTIVE
To determine the angiocardiographic findings in patients with unstable angina showing biphasic inversion of T-waves in precordial leads on electrocardiogram, commonly referred to as the Wellen's syndrome.
METHODS
The descriptive, cross-sectional study was carried out at the National Institute of Cardiovascular Diseases, Karachi, between February and November, 2010. Using convenience sampling, the first 100 consecutive patients showing the characteristic electrocardiogram pattern with a history of chest pain indicative of unstable angina and undergoing coronary angiography were included. Data was collected with the aid of a questionnaire to assess the coronary risk factors, and angiographic findings were recorded during cardiac catherisation of the patients. All the data collected was sorted and analysed on SPSS version 16 for statistical analysis.
RESULTS
Biphasic T-wave inversion was seen most commonly in leads v2-v3 in 26 (26%) patients, and in leads v2-v4 in 25 (25%) patients. Angiographic findings revealed that 50 (50%) patients had coronary artery stenosis in the proximal part of the left anterior descending artery, while 22 (22%) showed the occlusion in the middle segment. Right coronary artery established the dominance of heart in 75 (75%) of the patients and the two-vessel disease was most commonly observed during cardiac catherisation.
CONCLUSION
The classical pattern of biphasic T-wave inversion on electrocardiogram was seen associated with stenosis in the proximal as well as middle part of the left anterior descending coronary artery. This electrocardiogram pattern may not be well defined during the symptomatic phase of acute ischaemia and, hence, maybe overlooked. Prompt recognition and early intervention may significantly reduce morbidity and mortality in such patients.

Authors

Akhtar P, Rizvi SN, Tahir F, Saleem D, Mulla J, Saghir T

Institution

National Institute of Cardiovascular Diseases, Karachi.

Source

JPMA. The Journal of the Pakistan Medical Association 62:6 2012 Jun pg 548-51

MeSH

Angina, Unstable
Coronary Angiography
Coronary Stenosis
Cross-Sectional Studies
Electrocardiography
Female
Heart Catheterization
Humans
Male
Middle Aged
Pakistan
Questionnaires
Risk Factors
Syndrome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22755337