The Widow Marker, An EKG Sign We Should Not Miss

A 62-year-old male went to the emergency room presenting precordial pain. His electrocardiogram (EKG) showed sinus rhythm at 63bpm, with biphasic T waves, with initial positivity and terminal negativity in leads V2 and V3, and deeply and symmetrical inverted T waves in leads V4, V5 and V6 (Figure 1). A Wellens type A pattern was identified compatible with acute myocardial ischemia. The emergent coronary angiography revealed sub occlusive lesion of the left anterior descending artery (LAD) in the proximal portion (Figure 2). The Wellens syndrome represents an electrocardiographic pattern compatible with acute coronary syndrome.