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Wellens Syndrome

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41. Diabetes, Pre-Diabetes and Cardiovascular Diseases

Interventions Table of Contents 1. Preamble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3039 2. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3040 3. Abnormalities of glucose metabolism and cardiovascular disease 3041 3.1 De?nition, classi?cation and diagnosis . . . . . . . . . . . . .3041 3.2 Epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3043 3.3 Screening for disorders of glucose metabolism . . . . . . .3043 3.4 Disorders (...) of glucose metabolism and cardiovascular disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3044 3.5 Delaying conversion to type 2 diabetes mellitus . . . . . . .3046 3.6 Recommendations for diagnosis of disorders of glucose metabolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3046 4. Molecular basis of cardiovascular disease in diabetes mellitus . .3046 4.1 The cardiovascular continuum in diabetes mellitus . . . . .3046 4.2 Pathophysiology of insulin

2013 European Society of Cardiology

42. Wellens' syndrome, no culprit, what happened?

Wellens' syndrome, no culprit, what happened? Dr. Smith's ECG Blog: Wellens' syndrome, no culprit, what happened? Saturday, October 29, 2011 A 55 yo male with h/o smoking complained of 4 days of intermittent chest pain lasting up to a few hours each day. He presented to the ED pain free and had the following ECG at 1332: There is a suggestion of terminal T-wave inversion in V2, highly suggestive for early Wellens' syndrome. There is T-wave inversion in I and aVL diagnostic of ACS. The first (...) troponin returned with "minor increase" on a qualitative troponin I, so another quantitative troponin was sent and it was elevated at 0.325 ng/ml. The patient remained pain free. Another ECG was recorded at 1555: The T-wave inversion is more pronounced in V2, an evolution diagnostic of Wellens' syndrome. TWI in aVL again is clearly ischemic. . The patient was admitted to the hospital late on a Friday, and put on antithrombotics and antiplatelet agents. His troponin I peaked at 1.05 ng/ml that day

2011 Dr Smith's ECG Blog

43. Two case reports of Wellens’ syndrome Full Text available with Trip Pro

Two case reports of Wellens’ syndrome Wellens' syndrome is characterised by particular changes in electrocardiogram (ECG) precordial lead T-waves accompanied by proximal stenosis of the left anterior descending (LAD) artery. Two cases of electrocardiographic changes associated with Wellens' syndrome are presented here. Case 1, a 55-year-old female, was transferred to the First Affiliated Hospital of Xi'an Jiaotong University with intermittent and laborious angina pectoris. Her first ECG (...) in patients with characteristic ECGs, however, Wellens' syndrome has a wide spectrum of clinical manifestations and the ECG patterns may manifest itself persistently over a period of weeks. Therefore, ECG parameters should be combined with coronary angiography to confirm the presence of lesions.

2018 The Journal of international medical research

44. Wellens' syndrome and other electrocardiographic changes in a patient with a left anterior descending artery subocclusion associated with a left main coronary artery subocclusion. (Abstract)

have a higher incidence of left main coronary artery (LMCA) and proximal left anterior descending (LAD) coronary artery disease compared to patients with stable angina pectoris. In 1982, Wellens and colleagues described two electrocardiographic patterns that were predictive of critical narrowing of the proximal LAD artery, and were subsequently termed Wellens' syndrome. The criteria were: a) prior history of chest pain, b) little or no cardiac enzyme elevation, c) no pathologic precordial ST (...) Wellens' syndrome and other electrocardiographic changes in a patient with a left anterior descending artery subocclusion associated with a left main coronary artery subocclusion. Changing axis deviation has been reported also during atrial fibrillation or atrial flutter. Changing axis deviation has been also reported during acute myocardial infarction associated with atrial fibrillation too or at the end of atrial fibrillation during acute myocardial infarction. Patients with unstable angina

2011 International journal of cardiology

45. Aborted Myocardial Infarction in a Patient with Rapid Progression of Wellens Syndrome. (Abstract)

Aborted Myocardial Infarction in a Patient with Rapid Progression of Wellens Syndrome. Wellens syndrome refers to a distinct electrocardiographic pattern of deeply inverted or biphasic T waves in the anterior precordial leads, in the presence of critical proximal stenosis of the left anterior descending coronary artery (LAD). The natural history of the syndrome is an extensive myocardial infarction within weeks of hospital admission.This report describes a 63-year-old man in whom typical (...) electrocardiographic signs of Wellens syndrome advanced to persistent ST-segment elevation within 7min of presentation. Extensive anterior myocardial infarction (AMI) was aborted by primary percutaneous coronary intervention of a sub-occluded proximal LAD.Given the large area of the left ventricle supplied by a sub-occluded LAD, devastating AMI could have been expected and may have resulted in serious ventricular dysfunction and death. Therefore, early recognition of Wellens syndrome is essential and can

2011 Journal of Emergency Medicine

46. Takotsubo Cardiomyopathy Presenting as Wellens’ Syndrome Full Text available with Trip Pro

Takotsubo Cardiomyopathy Presenting as Wellens’ Syndrome Takotsubo cardiomyopathy, also known as apical ballooning syndrome and stress cardiomyopathy, is a transient systolic and diastolic left ventricular dysfunction with a variety of cardiac wall-motion abnormalities that is increasingly being associated with significant morbidity and mortality. Wellens' syndrome is an electrocardiographic (ECG) pattern in a pain-free patient that is indicative of critical occlusion of the left anterior (...) descending coronary artery requiring immediate cardiac catheterization. The authors report a case of a patient presenting with ECG findings consistent with Wellens' syndrome that was later found to have Takotsubo cardiomyopathy with angiographically normal coronary arteries on cardiac catheterization after a seizure.

2017 Clinical Practice and Cases in Emergency Medicine

47. Wellen’s syndrome: Challenges in diagnosis Full Text available with Trip Pro

Wellen’s syndrome: Challenges in diagnosis Wellen's syndrome is a pre-infarction stage of coronary artery disease characterised by predefined clinical and electrocardiographic (ECG) criteria of a subgroup of patients with myocardial ischaemia. Early recognition and appropriate intervention of this syndrome carry significant diagnostic and prognostic value. We report this unusual syndrome in an elderly man who presented with recurrent angina and characteristic ECG changes as T-waves inversion (...) in the precordial leads, especially in V2-V6 during pain-free periods and ECG obtained during episodes of pain demonstrating upright T-waves with possible elevated ST segments from V1-V4. Cardiac enzymes were positive and coronary angiography revealed critical stenosis in the proximal left anterior descending artery. It is important to timely identify this condition and intervene appropriately as these patients may develop extensive myocardial infarction that carries a significant morbidity and mortality.

2015 Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia

48. Myocardial edema underlies dynamic T-wave inversion (Wellens' ECG pattern) in patients with reversible left ventricular dysfunction. (Abstract)

Myocardial edema underlies dynamic T-wave inversion (Wellens' ECG pattern) in patients with reversible left ventricular dysfunction. The Wellens' electrocardiogram (ECG) pattern of dynamic T-wave inversion in the anterior leads is observed in clinical conditions characterized by reversible left ventricular (LV) dysfunction (stunned myocardium), either ischemic or nonischemic. The pathophysiologic basis of this ECG pattern remains to be elucidated.The purpose of this study was to report (...) the contrast-enhanced cardiac magnetic resonance (CE-CMR) findings in 4 cases of Wellens' ECG pattern associated with transient LV dysfunction from a variety of clinical conditions such as myocardial bridge, coronary artery dissection, cholecystitis, and takotsubo syndrome.All patients underwent CE-CMR at the time of acute clinical manifestations and after 6 to 8 weeks of follow-up to assess the presence and dynamics of LV myocardial changes.In all patients, the Wellens' ECG abnormalities were associated

2011 Heart Rhythm

49. Omnious T-wave inversions: Wellens’ syndrome revisited Full Text available with Trip Pro

Omnious T-wave inversions: Wellens’ syndrome revisited Wellens' syndrome is characterized by T-wave changes in electrocardiogram (EKG) during pain-free period in a patient with intermittent angina chest pain. It carries significant diagnostic and prognostic value because this syndrome represents a pre-infarction stage of coronary artery disease involving proximal left anterior descending (LAD) artery, which can subsequently lead to extensive anterior myocardial infarctions (MIs) and even (...) death without coronary angioplasty. Therefore, it is crucial for every physician to recognize EKG features of Wellens' syndrome in order to take appropriate immediate intervention to reduce mortality and morbidity for MI. Here, we report a case of an overweight man with 35 pack-year of smoking history who presented to Easton Hospital with intermittent pressing chest pain of 5/6 times within 10 day-period and was found to have type A Wellens' sign, which was biphasic T-waves in precordial leads V2

2016 Journal of community hospital internal medicine perspectives

50. An incidental case of Wellens’ syndrome in a community emergency department Full Text available with Trip Pro

An incidental case of Wellens’ syndrome in a community emergency department 27313812 2016 06 17 2018 11 13 1920-8642 7 2 2016 World journal of emergency medicine World J Emerg Med An incidental case of Wellens' syndrome in a community emergency department. 153-6 10.5847/wjem.j.1920-8642.2016.02.012 Jaiswal Deep D Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. Boudreau Dan D Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. eng Journal Article

2016 World journal of emergency medicine

51. Lown-Ganong-Levine Syndrome (Diagnosis)

material copyrighted by 3rd parties. Close encoded search term (Lown-Ganong-Levine Syndrome) and Lown-Ganong-Levine Syndrome What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Most Popular Articles According to Cardiologists Recommended 2002 160097-overview Diseases & Conditions Diseases & Conditions 2010 tarka-trandolapril-verapamil-999433 Drugs Drugs 2010 cardizem-cd-diltiazem-342374 Drugs Drugs 2002 159222-overview Diseases & Conditions Diseases (...) . Circulation . 1973 Sep. 48(3):549-55. . Mandel WJ, Danzig R, Hayakawa H. Lown-Ganong-Levine syndrome. A study using His bundle electrograms. Circulation . 1971 Oct. 44(4):696-708. . Douglas JE, Mandel WJ, Danzig R, Hayakawa H. Lown-Ganong-Levine syndrome. Circulation . 1972 May. 45(5):1143-4. . Durrer D, Schuilenburg RM, Wellens HJ. Pre-excitation revisited. Am J Cardiol . 1970 Jun. 25(6):690-7. . Mahaim I. Kent's fibers and the A-V paraspecific conduction through the upper connections of the bundle

2014 eMedicine.com

52. Wolff-Parkinson-White Syndrome (Overview)

(Wolff-Parkinson-White Syndrome) and Wolff-Parkinson-White Syndrome What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Slideshow Most Popular Articles According to Cardiologists Recommended 2001 /viewarticle/911329 News News 2002 2500081-overview Diseases & Conditions Diseases & Conditions 2010 /viewarticle/911083 Self Assessment Self Assessment 2001 /viewarticle/909022 News News Need a Curbside Consult? Share cases and questions with Physicians (...) condition involving abnormal conductive cardiac tissue between the atria and the ventricles that provides a pathway for a reentrant tachycardia circuit, in association with supraventricular tachycardia (SVT). See the image below for a typical "preexcited" ECG. Classic Wolff-Parkinson-White electrocardiogram with short PR, QRS >120 ms, and delta wave. Signs and symptoms The clinical manifestations of WPW syndrome reflect the associated tachyarrhythmia episodes—rather than the anomalous ventricular

2014 eMedicine.com

53. Epidermal Nevus Syndrome (Overview)

, giving rise to Cowden disease. The combination of nevoid hypertrichosis, diffuse lipoatrophy, and epidermal nevus has been suggested as a possible new epidermal nevus syndrome. [ ] Thus, the epidermal nevus syndrome may be best viewed as a heterogeneous congenital disorder that includes both the keratinocytic epidermal nevus syndrome and sebaceous nevus syndrome. [ ] An individual patient may have the same postzygotic HRAS and KRAS gene mutations and be evident clinically with distinct features. Next (...) is not a genetic disorder that can be passed to future children. Previous References Happle R. Gustav Schimmelpenning and the syndrome bearing his name. Dermatology . 2004. 209(2):84-7. . Mall V, Heinen F, Uhl M, Wellens E, Korinthenberg R. CNS lipoma in patients with epidermal nevus syndrome. Neuropediatrics . 2000 Aug. 31(4):175-9. . Altman J, Mehregan AH. Inflammatory linear verrucose epidermal nevus. Arch Dermatol . 1971 Oct. 104(4):385-9. . Vidaurri-de la Cruz H, Tamayo-Sanchez L, Duran-McKinster C, de la

2014 eMedicine.com

54. Epidermal Nevus Syndrome (Treatment)

is protected by copyright, Copyright © 1994-2019 by WebMD LLC. This website also contains material copyrighted by 3rd parties. Close encoded search term (Epidermal Nevus Syndrome) and Epidermal Nevus Syndrome What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Most Popular Articles According to Dermatologists Recommended 2002 1117506-overview Diseases & Conditions Diseases & Conditions 2002 1058733-overview Diseases & Conditions Diseases & Conditions 2002 (...) and the syndrome bearing his name. Dermatology . 2004. 209(2):84-7. . Mall V, Heinen F, Uhl M, Wellens E, Korinthenberg R. CNS lipoma in patients with epidermal nevus syndrome. Neuropediatrics . 2000 Aug. 31(4):175-9. . Altman J, Mehregan AH. Inflammatory linear verrucose epidermal nevus. Arch Dermatol . 1971 Oct. 104(4):385-9. . Vidaurri-de la Cruz H, Tamayo-Sanchez L, Duran-McKinster C, de la Luz Orozco-Covarrubias M, Ruiz-Maldonado R. Epidermal nevus syndromes: clinical findings in 35 patients. Pediatr

2014 eMedicine.com

55. Lown-Ganong-Levine Syndrome (Treatment)

electrograms. Circulation . 1971 Oct. 44(4):696-708. . Douglas JE, Mandel WJ, Danzig R, Hayakawa H. Lown-Ganong-Levine syndrome. Circulation . 1972 May. 45(5):1143-4. . Durrer D, Schuilenburg RM, Wellens HJ. Pre-excitation revisited. Am J Cardiol . 1970 Jun. 25(6):690-7. . Mahaim I. Kent's fibers and the A-V paraspecific conduction through the upper connections of the bundle of His-Tawara. Am Heart J . 1947 May. 33(5):651-3. . Ometto R, Thiene G, Corrado D, et al. Enhanced A-V nodal conduction (Lown-Ganong (...) . 105(1):169-75. . Hattori T, Makiyama T, Akao M, et al. A novel gain-of-function KCNJ2 mutation associated with short-QT syndrome impairs inward rectification of Kir2.1 currents. Cardiovasc Res . 2012 Mar 15. 93(4):666-73. . Shah A, Hocini M, Haissaguerre M, Jaïs P. Non-invasive mapping of cardiac arrhythmias. Curr Cardiol Rep . 2015 Aug. 17 (8):60. . Wasmer K, Eckardt L. Management of supraventricular arrhythmias in adults with congenital heart disease. Heart . 2016 Jun 16. . Media Gallery ECG

2014 eMedicine.com

56. Wolff-Parkinson-White Syndrome (Treatment)

like to print? What would you like to print? Sections Wolff-Parkinson-White Syndrome Find Us On About Membership WebMD Network Editions All material on this website is protected by copyright, Copyright © 1994-2019 by WebMD LLC. This website also contains material copyrighted by 3rd parties. Close encoded search term (Wolff-Parkinson-White Syndrome) and Wolff-Parkinson-White Syndrome What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Slideshow (...) , thyroid disease, and anemia. Treatment must be individualized for each patient and should include individual risk assessment. [ ] Appropriate therapy for WPW syndrome is based on the likely prognosis and on the degree of symptoms the patient experiences. Specific subspecialty consultations are often needed and may include a cardiovascular specialist (adult or pediatric cardiologist) and/or an electrophysiologist (arrhythmia specialist) with expertise in invasive studies. Despite the importance of risk

2014 eMedicine.com

57. Lown-Ganong-Levine Syndrome (Overview)

material copyrighted by 3rd parties. Close encoded search term (Lown-Ganong-Levine Syndrome) and Lown-Ganong-Levine Syndrome What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Most Popular Articles According to Cardiologists Recommended 2002 160097-overview Diseases & Conditions Diseases & Conditions 2010 tarka-trandolapril-verapamil-999433 Drugs Drugs 2010 cardizem-cd-diltiazem-342374 Drugs Drugs 2002 159222-overview Diseases & Conditions Diseases (...) . Circulation . 1973 Sep. 48(3):549-55. . Mandel WJ, Danzig R, Hayakawa H. Lown-Ganong-Levine syndrome. A study using His bundle electrograms. Circulation . 1971 Oct. 44(4):696-708. . Douglas JE, Mandel WJ, Danzig R, Hayakawa H. Lown-Ganong-Levine syndrome. Circulation . 1972 May. 45(5):1143-4. . Durrer D, Schuilenburg RM, Wellens HJ. Pre-excitation revisited. Am J Cardiol . 1970 Jun. 25(6):690-7. . Mahaim I. Kent's fibers and the A-V paraspecific conduction through the upper connections of the bundle

2014 eMedicine.com

58. Lown-Ganong-Levine Syndrome (Follow-up)

electrograms. Circulation . 1971 Oct. 44(4):696-708. . Douglas JE, Mandel WJ, Danzig R, Hayakawa H. Lown-Ganong-Levine syndrome. Circulation . 1972 May. 45(5):1143-4. . Durrer D, Schuilenburg RM, Wellens HJ. Pre-excitation revisited. Am J Cardiol . 1970 Jun. 25(6):690-7. . Mahaim I. Kent's fibers and the A-V paraspecific conduction through the upper connections of the bundle of His-Tawara. Am Heart J . 1947 May. 33(5):651-3. . Ometto R, Thiene G, Corrado D, et al. Enhanced A-V nodal conduction (Lown-Ganong (...) . 105(1):169-75. . Hattori T, Makiyama T, Akao M, et al. A novel gain-of-function KCNJ2 mutation associated with short-QT syndrome impairs inward rectification of Kir2.1 currents. Cardiovasc Res . 2012 Mar 15. 93(4):666-73. . Shah A, Hocini M, Haissaguerre M, Jaïs P. Non-invasive mapping of cardiac arrhythmias. Curr Cardiol Rep . 2015 Aug. 17 (8):60. . Wasmer K, Eckardt L. Management of supraventricular arrhythmias in adults with congenital heart disease. Heart . 2016 Jun 16. . Media Gallery ECG

2014 eMedicine.com

59. Wolff-Parkinson-White Syndrome (Treatment)

like to print? What would you like to print? Sections Wolff-Parkinson-White Syndrome Find Us On About Membership WebMD Network Editions All material on this website is protected by copyright, Copyright © 1994-2019 by WebMD LLC. This website also contains material copyrighted by 3rd parties. Close encoded search term (Wolff-Parkinson-White Syndrome) and Wolff-Parkinson-White Syndrome What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Slideshow (...) , thyroid disease, and anemia. Treatment must be individualized for each patient and should include individual risk assessment. [ ] Appropriate therapy for WPW syndrome is based on the likely prognosis and on the degree of symptoms the patient experiences. Specific subspecialty consultations are often needed and may include a cardiovascular specialist (adult or pediatric cardiologist) and/or an electrophysiologist (arrhythmia specialist) with expertise in invasive studies. Despite the importance of risk

2014 eMedicine Emergency Medicine

60. Wolff-Parkinson-White Syndrome (Follow-up)

like to print? What would you like to print? Sections Wolff-Parkinson-White Syndrome Find Us On About Membership WebMD Network Editions All material on this website is protected by copyright, Copyright © 1994-2019 by WebMD LLC. This website also contains material copyrighted by 3rd parties. Close encoded search term (Wolff-Parkinson-White Syndrome) and Wolff-Parkinson-White Syndrome What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Slideshow (...) , thyroid disease, and anemia. Treatment must be individualized for each patient and should include individual risk assessment. [ ] Appropriate therapy for WPW syndrome is based on the likely prognosis and on the degree of symptoms the patient experiences. Specific subspecialty consultations are often needed and may include a cardiovascular specialist (adult or pediatric cardiologist) and/or an electrophysiologist (arrhythmia specialist) with expertise in invasive studies. Despite the importance of risk

2014 eMedicine.com

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