Presentation of a case with Wellens syndrome

This case report is about a 56-year-old male, farm worker with a history of being a smoker and suffering from high blood pressure, who was admitted at the Cardiology Care Department with the diagnosis of coronary artery disease –unstable angina–, because of chest pain related to physical effort and changes in the appearance threshold. Rest-electrocardiogram, painless, shows deep, symmetric negative T waves in anterior wall, without enzyme elevation; but during admission the patient evolves quickly, clinically and electrically, to an extensive anterior wall acute myocardial infarction, without responding to the fibrinolytic reperfusion therapy, and showing a ventricular tachycardia degenerating into ventricular fibrillation. There was no response to the maneuvers of cardiovascular resuscitation, thus, he dies. It is diagnosed postmortem as a Wellens syndrome, because necropsy showed severe atherosclerotic disease of the proximal segment of the left anterior descending coronary artery with extensive anterior transmural infarction

Presentación de un caso con síndrome de Wellens

This case report is about a 56-year-old male, farm worker with a history of being a smoker and suffering from high blood pressure, who was admitted at the Cardiology Care Department with the diagnosis of coronary artery disease –unstable angina–, because of chest pain related to physical effort and changes in the appearance threshold. Rest-electrocardiogram, painless, shows deep, symmetric negative T waves in anterior wall, without enzyme elevation; but during admission the patient evolves quickly, clinically and electrically, to an extensive anterior wall acute myocardial infarction, without responding to the fibrinolytic reperfusion therapy, and showing a ventricular tachycardia degenerating into ventricular fibrillation. There was no response to the maneuvers of cardiovascular resuscitation, thus, he dies. It is diagnosed postmortem as a Wellens syndrome, because necropsy showed severe atherosclerotic disease of the proximal segment of the left anterior descending coronary artery with extensive anterior transmural infarction.Se presenta el caso de un varón de 56 años de edad, obrero agrícola, con antecedentes de ser fumador y padecer de hipertensión arterial; que ingresa en el Servicio de Cardiología con el diagnóstico de cardiopatía isquémica –angina inestable–, por presentar dolor precordial relacionado con el esfuerzo físico y cambios en su umbral de aparición. El electrocardiograma en reposo, sin dolor, muestra ondas T negativas profundas, simétricas, en cara anterior, sin elevación enzimática; y durante el ingreso evoluciona de forma rápida, clínica y eléctricamente, a un infarto agudo de miocardio anterior extenso, sin respuesta a la terapia de reperfusión con fibrinolíticos, y aparición de una taquicardia ventricular que degenera en fibrilación ventricular, sin respuesta a las maniobras de reanimación cardiovascular, por lo que fallece. Se diagnostica post mortem como un síndrome de Wellens, pues la necropsia demostró enfermedad aterosclerótica grave del segmento proximal de la arteria coronaria descendente anterior con infarto transmural anterior extenso