WELLENS SYNDROME: A SERIES OF CASES REGULATED BY THE SERGIPE TELECARDIOLOGY SERVICE (Atena Editora)

Abstract

INTRODUCTION: Wellens Syndrome (WS), also known as “Anterior Descending Coronary T-wave Syndrome”, presents the following characteristics: previous history of chest pain; absence of pathological Q waves; normal progression of precordial R waves; little or no elevation of cardiac markers; small or no ST elevation; biphasic or symmetric and inverted T waves in V2 and V3, occasionally in V1, V4, V5 and V6. WS is difficult to diagnose and requires high clinical suspicion, since negative T waves are not only present in it. Because it is a serious condition that is difficult to diagnose, the recognition of electrocardiographic changes is essential to allow better outcomes in the management of the disease. Therefore, this article has as main objective to report 5 cases of Wellens Syndrome regulated by the Telecardiology Service in Sergipe, correlating electrocardiographic findings with angiographic changes to highlight the relevance of early management in the disease. CASES REPORTS: There were reported 5 cases of patients treated at the emergency room with complaints of chest pain, different electrocardiographic presentation, cardiac necrosis markers not always altered and due interventionist conduct with catheterization. DISCUSSION: Once the diagnosis of Wellens syndrome is made or suspected, a cardiologist must be consulted. Contact with an interventional cardiologist must be recommended because the definitive treatment is cardiac catheterization with percutaneous coronary intervention. It is important to note that Wellens patients are at increased risk of developing AMI even if treated with drug therapy alone. Therefore, definitive treatment is procedural. In the cases presented, the Telemedicine Services in Sergipe favored an early and accurate diagnosis through the analysis by a cardiologist of the changes present in the electrocardiogram suggestive of AMI. CONCLUSIONS: The patient with WS benefits from an early invasive strategy to reduce their rate of infarction and death, but to achieve this goal it must be recognized early. One of the most insightful strategies in this regard is the Telecardiology service.