Wellen's Syndrome Flashcards
Wellen’s syndrome is a change to the ______ of the ECG 2/2 ischemia.
A. PRI
B. QRS complex
C. ST segment
D. T-wave morphology
D. T-wave morphology
______ Wellen’s Syndrome occurs with biphasic T-waves.
A. Type A
B. Type B
A. Type A
______ Wellen’s Syndrome occurs with T-wave inversion.
A. Type A
B. Type B
B. Type B
(Type A/Type B) Wellen’s pattern is the most common presentation.
Type B - 75% of cases
T-wave changes are most often found in what leads with Wellen’s syndrome?
A. II, III, aVF
B. V2-V3
B. V4-V6
B. V2-V3
T/F: Wellen Syndrome may be diagnosed in the case of STEMI.
False. Dx criteria for Wellen’s requires there be isoelectric or minimally elevated (STE less than 1 mm) ST segments
In Wellen’s syndrome, R-wave progression occurs normally int he precordial (V1-V6) leads.
True
T/F: Wellen’s syndrome must be diagnosed by the presence of T-wave changes in a pain free patient.
True
What pulmonary condition may produce T-wave changes in the 12-lead ECG? This is also a DDx for Wellen’s.
Pulmonary embolism.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267566/
What is the finding on ECG indicative of pulmonary embolism?
S1Q3T3
Lead I: S-wave
Lead III: Q-wave
Lead III: T-wave inversion
S1Q3T3 is present in _____% of PE patients.
15-25%. Therefore, PE versus Type B Wellen’s may not always be ruled out.
Specifically, the presence of S1Q3T3 is a sign of what cardiac abnormality?
A. cor pulmonale
B. mitral stenosis
C. pulmonary embolism
A. cor pulmonale - A sign of right ventricular strain. When blood backs up into the right ventricle (which pumps blood to the pulmonary circulation), the RV becomes overloaded by blood. The Frank-Starling mechanism indicates that the RV should attempt to increase contractility to overcome this new pressure head of stagnant blood, but the RV STRAINS against it.
Incorrect:
B. mitral stenosis -
C. pulmonary embolism - Though PE may produce S1Q3T3 on ECG, embolism is an abnormality of blood in the lungs, NOT the heart. And no, this is is not splitting hairs.
Explain HOW right ventricular strain produces ECG changes.
By definition, strain is a “…repolarisation abnormality due to right ventricular hypertrophy or dilatation.”
delve into further when not so tired
Why is treatment/transport/evaluation of the pain-free Wellen’s patient important?
Wellen’s syndrome with T-wave changes indicate the patient is at risk for an anterior wall MI in the next 2-3 weeks.