How to never miss Wellen's syndrome

A succinct run-down of Wellen's syndrome type A and type B. How never to miss this abnormality, which signifies critical stenosis of the left anterior descending (LAD) coronary artery.

[@abudaniyal715]

Thanks

[@irynaYe]

What is written on the board there? 😊

[@RichardBody]

It’s my quote board - I try to write a new one each month. That one said “There’s no such uncertainty as a sure thing”. (Robert Burns) 😊

[@drabhimac]

What is the reason of getting 2 pattern s,type A and B according to pathophysiology and/or coronary anatomy..?

[@RichardBody]

Good question! I think it depends on the timing and degree of reperfusion. Wellens type A has terminal T inversion, suggesting early reperfusion after an LAD occlusion that has partially resolved. Wellens type B is likely the evolution over time after reperfusion, as the T wave inversion becomes symmetrical and complete. Steve Smith has written a really nice blog on this - hqmeded-ecg.blogspot.com/2013/11/why-we-need-12-lead-st-segment.html?m=1