Wellens Syndrome ECG Pattern
Wellens' syndrome: ECG pattern in unstable angina indicating critical proximal LAD stenosis. Two patterns: Type A (biphasic T waves V2-V3) and Type B (deep symmetric T-wave inversions V2-V3). High risk of anterior MI without intervention.
Score interpretation
Critical proximal LAD stenosis is likely; the pattern can precede an anterior MI within weeks.
→ Urgent cardiology review for angiography; avoid stress testing.
Not all criteria are met — consider other causes and mimics.
→ Manage per the ACS pathway and ECG findings; ST elevation with pain is a STEMI pathway.
Interpretation bands for the Wellens' Syndrome. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Fridericia Corrected QT Interval (QTcF) · ECG Interpretation
- Modified Sgarbossa's Criteria (Smith Modification) for MI in LBBB · ECG Interpretation
- Brugada Phenocopy Score · ECG Interpretation
- Lead aVR Sign for Left Main / Proximal LAD Occlusion · ECG Interpretation
- de Winter ECG Pattern for Proximal LAD Occlusion · ECG Interpretation
- Isosorbide Mononitrate (Stable Angina) · Nitrate / Stable Angina
- Nicorandil · Stable Angina
- Ranolazine · Refractory Stable Angina
- Glyceryl Trinitrate (Sublingual / IV) · Nitrate / Acute Angina
- Aciclovir 800mg Tablets (Ramsay Hunt Syndrome / Herpes Zoster Oticus) · Antiviral — nucleoside analogue (herpes zoster treatment)
- Pramipexole (Restless Legs Syndrome — Elderly) · Dopamine Agonist (D2/D3 Receptor)
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.