Variant of Wellen’s syndrome in type 1 diabetic patient: A case report

作     者：Mukosolu Florence Obi Manjari Sharma Vikhyath Namireddy Paul Gargiulo Chelsea Noel Cho Hyun Blossom De Gale 

作者机构：Internal MedicineWyckoff Heights Medical CenterBrooklynNY 11237United States Clinical RotationsSt Georges UniversitySchool of MedicineTrue Blue 96038Grenada 

出 版 物：《世界心脏病学杂志:英文版(电子版)》 (World Journal of Cardiology)

年 卷 期：2023年第15卷第9期

页      面：462-468页

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：Wellens’s syndrome Biphasic T waves Deeply inverted T waves Precordial leads Left anterior descending artery Pseudo-normalization Right coronary artery Left circumflex artery Case report 

摘      要：BACKGROUND Wellen’s syndrome is a form of acute coronary syndrome associated with proximal left anterior descending artery(LAD)stenosis and characteristic electro-cardiograph(ECG)patterns in pain free *** abnormal ECG pattern is classified into type A(biphasic T waves)and type B(deeply inverted T waves),based on the T wave pattern seen in the pericodial chest *** SUMMARY We present the case of a 37-year-old male with history of type 1 diabetes mellitus(T1DM),gastroparesis,mild peripheral artery disease and right toe cellulitis on IV antibiotics who presented to the emergency department with nausea,vomiting and abdominal pain for 3 d and as a result couldn’t take his *** to have fasting blood sugar 392 mg/*** for diabetic *** the hospital course,the patient was asymptomatic and denied any chest *** admission,No ECG and troponin draws were *** day 2,the patient became hypoxic with oxygen saturation 80%on room air,intermittent mild right-sided chest pain which he attributed to vomiting from his *** ECG done was significant for Biphasic T wave changes in leads V2 and V3 and elevated high sensitivity *** was transitioned to cardiac intensive care unit and cardiac catheterization performed with result significant for extensive coronary artery *** This case highlights an exceptional manifestation of Wellen s syndrome,wherein the right coronary artery and circumflex artery display a remarkable 100%constriction,alongside a proximal LAD stenosis of 90%-95%.Notably,this occurrence transpired in a patient grappling with extensive complications arising from ***,it underscores the utmost significance of promptly recognizing the presence of Wellen s syndrome and swiftly initiating appropriate medical intervention.