Wellen's Syndrome Flashcards

1
Q

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

A

D. T-wave morphology

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2
Q

______ Wellen’s Syndrome occurs with biphasic T-waves.

A. Type A
B. Type B

A

A. Type A

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3
Q

______ Wellen’s Syndrome occurs with T-wave inversion.

A. Type A
B. Type B

A

B. Type B

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4
Q

(Type A/Type B) Wellen’s pattern is the most common presentation.

A

Type B - 75% of cases

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5
Q

T-wave changes are most often found in what leads with Wellen’s syndrome?

A. II, III, aVF
B. V2-V3
B. V4-V6

A

B. V2-V3

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6
Q

T/F: Wellen Syndrome may be diagnosed in the case of STEMI.

A

False. Dx criteria for Wellen’s requires there be isoelectric or minimally elevated (STE less than 1 mm) ST segments

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7
Q

In Wellen’s syndrome, R-wave progression occurs normally int he precordial (V1-V6) leads.

A

True

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8
Q

T/F: Wellen’s syndrome must be diagnosed by the presence of T-wave changes in a pain free patient.

A

True

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9
Q

What pulmonary condition may produce T-wave changes in the 12-lead ECG? This is also a DDx for Wellen’s.

A

Pulmonary embolism.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267566/

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10
Q

What is the finding on ECG indicative of pulmonary embolism?

A

S1Q3T3

Lead I: S-wave
Lead III: Q-wave
Lead III: T-wave inversion

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11
Q

S1Q3T3 is present in _____% of PE patients.

A

15-25%. Therefore, PE versus Type B Wellen’s may not always be ruled out.

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12
Q

Specifically, the presence of S1Q3T3 is a sign of what cardiac abnormality?

A. cor pulmonale
B. mitral stenosis
C. pulmonary embolism

A

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.

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13
Q

Explain HOW right ventricular strain produces ECG changes.

A

By definition, strain is a “…repolarisation abnormality due to right ventricular hypertrophy or dilatation.”

delve into further when not so tired

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14
Q

Why is treatment/transport/evaluation of the pain-free Wellen’s patient important?

A

Wellen’s syndrome with T-wave changes indicate the patient is at risk for an anterior wall MI in the next 2-3 weeks.

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