Wellens syndrome
Also calledWellens sign · Wellens' syndrome · Wellens pattern · LAD coronary T-wave syndrome
Definition
A pattern of deeply biphasic (type A) or deeply and symmetrically inverted (type B) T waves in the precordial leads V2 to V3 (sometimes extending to other precordial leads), recorded during a pain-free interval after an episode of angina and signifying a critical stenosis high in the left anterior descending artery. Characteristic features are no more than minimal ST elevation (not over 1 mm), no precordial Q waves or loss of R waves, normal precordial R wave progression, and normal or only mildly elevated cardiac markers. It identifies a subgroup at high risk of extensive anterior wall infarction.
Sources
- de Zwaan C, Bar FW, Wellens HJ. Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction. Am Heart J. 1982;103(4 Pt 2):730-736. doi.org/10.1016/0002-8703(82)90480-x
- Rhinehardt J, Brady WJ, Perron AD, Mattu A. Electrocardiographic manifestations of Wellens' syndrome. Am J Emerg Med. 2002;20(7):638-643. doi.org/10.1053/ajem.2002.34800
- Zhang Y, Shen Y. Advances in the study of Wellens syndrome. J Int Med Res. 2025;53(3):3000605251324480. doi.org/10.1177/03000605251324480
- Wagner GS, Macfarlane P, Wellens H, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part VI: acute ischemia/infarction. Circulation. 2009;119(10):e262-e270. doi.org/10.1161/CIRCULATIONAHA.108.191098
Last reviewed 2 October 2026. Every definition in the EKG Dictionary cites the guideline, consensus statement or original paper it comes from.