The Wellens’ sign is one of the most distinctive cardiological signs of impending danger. It is so unique that people who have been found to have it have an up to a 65% chance of having a major heart attack. The Wellens’ sign, also commonly referred to as the “coronary T wave syndrome” or also “Wellens Syndrome” appears in a person’s ECG, usually during a pain-free period for a patient having intermittent chest pain. It is defined as a symmetrical inversion in the T waves on the ECG leads that are placed across the chest. The Wellens sign “evolves”, moving from a normal ECG towards a more obvious looking version of itself as the injury to the heart muscle happens.
Wellens’ Syndrome: Progression of ECG changes.
The Wellens’ sign was described in 1982 by Dr. Hein J.J. Wellens and his team of colleagues in an article published in the American Heart Journal. They looked at the ECGs of 145 people having unstable angina in an attempt to discern specific patterns of danger. Among the group of persons studied, those having the Wellens’ sign were found to be especially vulnerable. Up to 75% of the patients who went untreated developed into an acute anterior wall MI within a few days to weeks. The sign is up to 69% sensitive for detecting a major blockage in the heart’s main artery; a blockage, that if it were to close up completely could seriously impair blood supply to the heart and risk a person’s life. Stress testing a patient with a Wellens’ sign is contraindicated. Instead, they should undergo immediate cardiac catheterization.
99% blockage in the Left Anterior Descending Artery of a patient with Wellens’ syndrome.