ECG Clues and Antiplatelet Therapy in Wellens’ Syndrome

Cardiology

Wellens’ syndrome is a high-risk pre-infarction state associated with critical proximal left anterior descending artery stenosis. It is characterised by deeply inverted or biphasic T waves in the anterior ECG leads, particularly V2-V3, during pain-free periods. Early recognition is essential, as stress testing may precipitate extensive anterior myocardial infarction. Contemporary management includes urgent coronary angiography, percutaneous coronary intervention, and guideline-directed dual antiplatelet therapy with aspirin and potent P2Y12 inhibitors to improve cardiovascular outcomes. Please participate in the quiz and share your opinion on ECG clues and antiplatelet therapy in Wellens’ syndrome.

Which ECG finding is most characteristic of Wellens’ syndrome?

• Deeply inverted or biphasic T waves in V2-V3
• Diffuse ST elevation
• Complete heart block
• Prominent delta waves

Which antiplatelet regimen is preferred in PCI candidates with Wellens’ syndrome?

• Aspirin with Ticagrelor or Prasugrel
• Aspirin alone
• Warfarin monotherapy
• Heparin alone