Scholarlink

Background <p>Wellens syndrome is a high-risk non–ST-elevation acute coronary syndrome (NSTE- ACS) pattern associated with critical stenosis of the left anterior descending (LAD) artery and impending anterior myocardial infarction. Despite being described decades ago, it remains under-recognized outside cardiology practice. This narrative review aimed to synthesize contemporary evidence on the epidemiology, diagnostic features, differential diagnosis, and management of Wellens syndrome within current clinical frameworks.</p> Methods <p>A narrative review was conducted following the SANRA quality framework. A targeted literature search of PubMed, Embase, Scopus, and Google Scholar was performed for studies published between 1980 and 2025 using keywords related to Wellens syndrome and anterior T-wave inversion. Original studies, cohort analyses, guidelines, and high-quality reviews were included, while non-English articles, duplicates, and case reports without angiographic confirmation were excluded.</p> Results <p>Wellens syndrome is characterized by biphasic or deeply inverted T waves in leads V2– V3, often appearing during pain-free intervals, with cardiac troponin levels frequently normal or minimally elevated. Contemporary cohorts demonstrate that early recognition and prompt revascularization significantly improve outcomes compared with historical experience. Differentiation between true and pseudo-Wellens patterns is essential, as multiple non-ischemic conditions can mimic the electrocardiographic (ECG) appearance. Current management typically aligns with high-risk NSTE-ACS pathways, emphasizing early invasive evaluation and avoidance of stress testing before exclusion of critical ischemia.</p> Conclusions <p>Wellens syndrome remains an important but under-recognized marker of critical LAD ischemia. Early ECG recognition and pathway-based management are essential to prevent extensive anterior myocardial infarction. Increased clinician awareness and future research focusing on risk stratification, digital ECG detection, and standardized follow-up strategies may further improve outcomes.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Wellens Syndrome in the Modern Era: A Contemporary Review

  • 期刊论文

  • 发表日期：

    2026年4月9日

查看全文
  • Ai Cao My Bui,
  • Nghia Phu Nguyen,
  • Van-Phu Tran,
  • Quy Tran,
  • Minh Vu Phuc Ha,
  • Nhu Hoang,
  • Hung Minh Ngo,
  • Phillip Tran

摘要

Background

Wellens syndrome is a high-risk non–ST-elevation acute coronary syndrome (NSTE- ACS) pattern associated with critical stenosis of the left anterior descending (LAD) artery and impending anterior myocardial infarction. Despite being described decades ago, it remains under-recognized outside cardiology practice. This narrative review aimed to synthesize contemporary evidence on the epidemiology, diagnostic features, differential diagnosis, and management of Wellens syndrome within current clinical frameworks.

Methods

A narrative review was conducted following the SANRA quality framework. A targeted literature search of PubMed, Embase, Scopus, and Google Scholar was performed for studies published between 1980 and 2025 using keywords related to Wellens syndrome and anterior T-wave inversion. Original studies, cohort analyses, guidelines, and high-quality reviews were included, while non-English articles, duplicates, and case reports without angiographic confirmation were excluded.

Results

Wellens syndrome is characterized by biphasic or deeply inverted T waves in leads V2– V3, often appearing during pain-free intervals, with cardiac troponin levels frequently normal or minimally elevated. Contemporary cohorts demonstrate that early recognition and prompt revascularization significantly improve outcomes compared with historical experience. Differentiation between true and pseudo-Wellens patterns is essential, as multiple non-ischemic conditions can mimic the electrocardiographic (ECG) appearance. Current management typically aligns with high-risk NSTE-ACS pathways, emphasizing early invasive evaluation and avoidance of stress testing before exclusion of critical ischemia.

Conclusions

Wellens syndrome remains an important but under-recognized marker of critical LAD ischemia. Early ECG recognition and pathway-based management are essential to prevent extensive anterior myocardial infarction. Increased clinician awareness and future research focusing on risk stratification, digital ECG detection, and standardized follow-up strategies may further improve outcomes.