Wellen's syndrome caused by severe ostial stenosis of the left main coronary artery: a case report.

Background: Wellen's syndrome may indicate severe stenosis or even occlusion of the proximal left anterior descending coronary artery. It may progress to acute myocardial infarction. Early recognition and an early invasive strategy are critical to avoiding impending myocardial injury. To our knowledge, only one case of Wellen's electrocardiogram patterns caused by left main coronary artery (LM) lesions has been reported.

Case presentation: A 61-year-old man with a history of hypertension and smoking presented to the emergency department complaining of paroxysmal chest pain for the preceding 6 days. In the present case, the T-wave symmetric inversions in the V2 and V3 leads is associated with severe ostial stenosis of LM, which appears similar to Wellen's type B pattern.

Conclusions: Practitioners should familiarize themselves with such uncommon LM lesions patterns and perform emergent reperfusion therapy.