Wellens’Syndream(웰렌증후군) – Patternofabnormal Twavesintheprecordial leads V2,V3related with ★critical stenosis of LADartery Type : 75% ofpatients with wellen SDhaveinverted Twaves, and 25%patientshavebiphasic Twavesinthesameleads. – InV4orV5, V6 arterybarterybulybuly; normalize when pain recurs. – InV4orV5, V6 arterybulybulybuly; normalize when pain recurs – Up to 15% of patienting with unstable w
인터벤션이 제일 중요하다. Unstableangina에 준하여 aspirin, anticoagulant, BB(저혈압이 아니면), nitrate도 가능하지만 인터벤션이 가장 중요함. definitive treatment for Wellen is procedure.
V2부터 V5까지 Twave inversion을 보여준다.
WellenBiphasic Type// 뜬 T, 엎어진 T의 양쪽이 있는 General Criteria for Wellens’Syndrome·History of episodic chest pain consistent with unstable angina·During pain, the ECG may not display abnormal T waves·When pain free, abnormal T waves seen, most prominent in leads V2 and V3, often in leads V1 and V4, and occasionally in leads V5 and V6·Deep symmetric T-wave inversion seen in about 75%of Wellens’syndrome patients • Biphasic T waves seen in about 25% of Wellens’syndrome patients • No pathologic Q waves or loss of R waves • Normal or minimally elevated ST segments • Normal or minimally elevated cardiac biomarkers
Dewinter Syndrome (드윈터) · Anterior ★ STEMIequivalent thatpresents withoutobvious STsegmentelevation · Keydiagnosticfeatures : STdepression and peaked Twavesintheprecordial leads. · Thede Winterpatternissegmentelevation · Keydiagnosticfeatures : STdeaked Twavesintheprecordial leads.
Dewinter SD
Sgarbossacriteria Concordant ST elevation > 1mm(inany lead) = Most specific for MI in LBB, Concordant ST depression > 1mm(in V1, V2or V3) = specific for MI in LBB, discordant ST elevation > 5mm = lessspecific for MI in LBBB
Sgarbossa
Scoring하여 LBB로 급성심근경색 진단