Recognizing Wellens Syndrome in a Family Practice Setting

Wellens syndrome is an Electrocardiographic (ECG) pattern that is associated critical stenosis of the Left Anterior Descending (LAD) artery. It manifests as either biphasic T waves in V2-V3 (type A) or deeply negative T waves in V2-V4 (type B). These T-wave abnormalities are persistent and can endure for hours to weeks. Patients with Wellens syndrome often lack chest pain and typically display normal or slightly elevated cardiac enzyme levels. It is critical for clinicians working in both outpatient and inpatient clinical settings to understand and recognize these ECG changes and its association with critical LAD obstruction and significant risk of anterior wall myocardial infarction. In this case report, we present a unique case of Wellens syndrome type B in an asymptomatic 83-year-old male patient initially assessed and evaluated in an outpatient family practice clinical setting.