A 52-year-old man presents with recurrent episodes of rest chest pain over the past 24 hours. Between pain episodes, his ECG shows deeply inverted and biphasic T waves in leads V2 and V3. Cardiac troponin I is mildly elevated at 0.8 ng/mL. Coronary angiography reveals a critical stenosis of the proximal left anterior descending artery. Which term best describes this ECG pattern?
- A Wellens syndrome ✓
- B De Winter T-wave pattern
- C Hyperacute T waves
- D Subendocardial ischemia pattern
Correct answer: A. Wellens syndrome
Explanation
Wellens syndrome is characterized by deeply inverted or biphasic T waves in V2-V3, indicating critical proximal LAD stenosis. It signals high-risk unstable angina requiring urgent revascularization. De Winter pattern shows upsloping ST depression with tall T waves and is equivalent to STEMI. Hyperacute T waves are broad, tall, and appear early in STEMI.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.