CASE REPORT OF PSEUDO-WELLENS’ SYNDROME AND MYOCARDIAL BRIDGING IN A YOUNG WOMAN

Abstract

The clinical entity in which Wellens' electrocardiographic changes occur in normal coronary arteriesconfirmed by angiography is defined as Pseudo Wellens syndrome. Myocardial bridging is a condition wheremuscle fibers abnormally bridge the intramyocardial passage of an epicardial coronary artery, which subsequentlybecomes a tunneled pathway beneath them. It is most commonly found in the middle segment of the left anteriordescending 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 fewmonths ago, but today is more pronounced. After consultation, she was hospitalized at the cardiology department forfurther treatment and investigation. An electrocardiogram showed sinus rhythm with inverted T waves in precordialleads V2 to V5. She underwent distal transradial coronary angiography on the same day, which revealed mid-LADsegment 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 differentialdiagnosis of inverted T waves in a young subpopulation at presentation of acute coronary syndrome.