CASE REPORT OF PSEUDO-WELLENS’ SYNDROME AND MYOCARDIAL BRIDGING IN A YOUNG WOMAN
DOI:
https://doi.org/10.35120/kij5404597kKeywords:
pseudo-wellens’ syndrome, myocardial bridging, myocardial bridge, distal transradial coronary angiographyAbstract
The clinical entity in which Wellens' electrocardiographic changes occur in normal coronary arteries
confirmed by angiography is defined as Pseudo Wellens syndrome. Myocardial bridging is a condition where
muscle fibers abnormally bridge the intramyocardial passage of an epicardial coronary artery, which subsequently
becomes a tunneled pathway beneath them. It is most commonly found in the middle segment of the left anterior
descending artery (LAD) (70% to 90% of cases). It is recognized as the most common congenital coronary anomaly.
Case report: A 49-year-old woman came to the emergency room because of tightness in her chest that she had a few
months ago, but today is more pronounced. After consultation, she was hospitalized at the cardiology department for
further treatment and investigation. An electrocardiogram showed sinus rhythm with inverted T waves in precordial
leads V2 to V5. She underwent distal transradial coronary angiography on the same day, which revealed mid-LAD
segment systolic compression (10 mm) consistent with myocardial bypass.
The clinician should be aware of MB as a potential cause of pseudo-Wellens syndrome and in the differential
diagnosis of inverted T waves in a young subpopulation at presentation of acute coronary syndrome.
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