Open Access

Pseudo‑Wellens syndrome in an elderly female patient with pulmonary embolism: A case report

  • Authors:
    • Swara H. Abdullah
    • Shaho F. Ahmed
    • Bnar J. Hama Amin
    • Dana H. Mohammed‑Saeed
    • Soran H. Tahir
    • Fattah H. Fattah
    • Berun A. Abdalla
    • Fahmi H. Kakamad
  • View Affiliations

  • Published online on: March 20, 2023     https://doi.org/10.3892/mi.2023.78
  • Article Number: 18
  • Copyright: © Abdullah et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Pseudo‑Wellens syndrome refers to any electrocardiogram (ECG) pattern that mimics Wellens syndrome with no critical left anterior descending (LAD) artery‑associated coronary artery disease. The present study describes a rare case of pseudo‑Wellens syndrome associated with pulmonary embolism. A female patient presented with chest tightness for 72 h. The precordial examination and heart sounds were normal. A mild bilateral lower pitting leg edema with a superficial varicose vein was observed. The levels of C‑reactive protein (98.80 mg/l) and D‑dimer (7599.9 ng/ml) were abnormal. An electrocardiogram presented a biphasic inversion of the T‑wave in precordial leads in the pain‑free interval. Coronary angiography did not reveal any notable findings. A computed tomography pulmonary angiography demonstrated an acute pulmonary embolism. The patient received unfractionated heparin (20,000 IU) by intravenous infusion. She was discharged on rivaroxaban (15 mg) twice daily for 21 days. The inverted T‑wave specificity, sensitivity and positive predictive values for LAD stenosis are 89, 69 and 86% respectively. This indicates that ECG alternations with the properties of Wellens syndrome do not always guarantee its occurrence, and in the presence of a normal coronary artery, the condition may be pseudo‑Wellens syndrome. The case described herein suggests that clinicians need to carefully screen patients that have pulmonary embolisms with an abnormal electrocardiographic pattern in order to prevent unnecessary intervention.
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March-April 2023
Volume 3 Issue 2

Print ISSN: 2754-3242
Online ISSN:2754-1304

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Spandidos Publications style
Abdullah SH, Ahmed SF, Hama Amin BJ, Mohammed‑Saeed DH, Tahir SH, Fattah FH, Abdalla BA and Kakamad FH: Pseudo‑Wellens syndrome in an elderly female patient with pulmonary embolism: A case report. Med Int 3: 18, 2023.
APA
Abdullah, S.H., Ahmed, S.F., Hama Amin, B.J., Mohammed‑Saeed, D.H., Tahir, S.H., Fattah, F.H. ... Kakamad, F.H. (2023). Pseudo‑Wellens syndrome in an elderly female patient with pulmonary embolism: A case report. Medicine International, 3, 18. https://doi.org/10.3892/mi.2023.78
MLA
Abdullah, S. H., Ahmed, S. F., Hama Amin, B. J., Mohammed‑Saeed, D. H., Tahir, S. H., Fattah, F. H., Abdalla, B. A., Kakamad, F. H."Pseudo‑Wellens syndrome in an elderly female patient with pulmonary embolism: A case report". Medicine International 3.2 (2023): 18.
Chicago
Abdullah, S. H., Ahmed, S. F., Hama Amin, B. J., Mohammed‑Saeed, D. H., Tahir, S. H., Fattah, F. H., Abdalla, B. A., Kakamad, F. H."Pseudo‑Wellens syndrome in an elderly female patient with pulmonary embolism: A case report". Medicine International 3, no. 2 (2023): 18. https://doi.org/10.3892/mi.2023.78