WHEN WELLEN'S SYNDROME MEETS BRUGADA PHENOCOPY

Abstract

Wellens' syndrome, or Widow Maker, is referred to as a pre-infarctionsyndrome with non classical ischemic electrocardiographic (ECG) changes andunremarkable cardiac biomarkers. This syndrome should not be missed by theclinicians as delay in urgent coronary intervention can result in anterior wallmyocardial infarction (MI), arrhythmias, left ventricular dysfunction and death. Itcan be predicted by patient's history and ECG changes. Thus, physicians andhealth care providers should be familiar with the electrocardiographicmanifestations of Wellens' Syndrome. Here, we describe a case of middle agedmale patient presenting with history of typical chest pain with slightly elevatedblood pressure (BP) with an initial ECG showing Brugada pattern, patient wasadmitted and started with antiplatelets, anti-ischemic and anticoagulant followedby serial ECGs but after 10 hours ECG done showed wellenoid pattern for whichhe underwent a Coronary Angiography and it came out to be severe lesion inproximal left anterior descending (LAD) artery. Key Words: Wellens, Brugada, Anterior wall MI, Left anterior descending,Ischemia, ECG changes, Angiography