📈 Wellens Syndrome ECG Pattern
UseWhen to use: resolved angina with biphasic or deep inverted V2–V3 T waves.
StrataFull pattern → urgent cardiology / early angiography pathway.
LimitsWhen not to use: active STEMI ST elevation — treat as STEMI. · Pitfall: dismissing deep inversions as nonspecific. · Incomplete bundle still warrants ACS caution.
Sourcede Zwaan C, Wellens et al. Am Heart J (Wellens)
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
Type A vs B.
When to use
When to use: resolved angina with biphasic or deep inverted V2–V3 T waves.
How it works
Type A biphasic or Type B deep inversion + ST/R-wave/enzyme/history bundle.
Key points
- Type A vs B.
- Avoid stress test.
- Next: ACS pathway / cath lab.
References
- de Zwaan C, Wellens et al. Am Heart J (Wellens)
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Precordial T-wave pattern (V2–V3 ± V1–V6) | Type A — biphasic T waves (plus-minus) |
|---|---|
| Isoelectric or minimally elevated ST (<1 mm) — no ongoing STEMI ST elevation | No |
| Preserved R-wave progression / no pathologic precordial Q waves of completed infarct | No |
| Recent anginal chest pain that has largely resolved at time of ECG | No |
| Cardiac enzymes normal or only minimally elevated | No — clear enzyme rise / evolving MI |
→WellensIncomplete pattern
- T-wave type present：Type A
- Unmet：ST criterion, R-wave / Q-wave criterion, resolved angina history, enzyme criterion
| Precordial T-wave pattern (V2–V3 ± V1–V6) | Neither pattern |
|---|---|
| Isoelectric or minimally elevated ST (<1 mm) — no ongoing STEMI ST elevation | No |
| Preserved R-wave progression / no pathologic precordial Q waves of completed infarct | No |
| Recent anginal chest pain that has largely resolved at time of ECG | No |
| Cardiac enzymes normal or only minimally elevated | No — clear enzyme rise / evolving MI |
→WellensPattern not met
- Next：Manage by standard ACS / ECG differential
Verification & sources · governance
FAQ
Frequently asked questions
- Does Wellens Syndrome ECG Pattern upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Wellens Syndrome ECG Pattern calculated in practice? Can you show a worked example?
- Inputs: Precordial T-wave pattern (V2–V3 ± V1–V6) Type A — biphasic T waves (plus-minus), Isoelectric or minimally elevated ST (<1 mm) — no ongoing STEMI ST elevation No, Preserved R-wave progression / no pathologic precordial Q waves of completed infarct No, Recent anginal chest pain that has largely resolved at time of ECG No, Cardiac enzymes normal or only minimally elevated No — clear enzyme rise / evolving MI → Result: Wellens Incomplete pattern（T-wave type present: Type A, Unmet: ST criterion, R-wave / Q-wave criterion, resolved angina history, enzyme criterion） Inputs: Precordial T-wave pattern (V2–V3 ± V1–V6) Neither pattern, Isoelectric or minimally elevated ST (<1 mm) — no ongoing STEMI ST elevation No, Preserved R-wave progression / no pathologic precordial Q waves of completed infarct No, Recent anginal chest pain that has largely resolved at time of ECG No, Cardiac enzymes normal or only minimally elevated No — clear enzyme rise / evolving MI → Result: Wellens Pattern not met（Next: Manage by standard ACS / ECG differential）