Myocardial Bridge of the Left Anterior Descending Artery Causing Pseudo-Wellens’ Syndrome: A Report of Two Cases
Introduction: Wellens’ syndrome represents an important, at times overlooked, spectrum of left anterior descending (LAD) coronary artery occlusion, spontaneous reperfusion, and impending reocclusion. Once considered pathognomonic for a thromboembolic coronary event, an increasing number of clinical...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2023-05-01
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| Series: | Clinical Practice and Cases in Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/9tq45130 |
| _version_ | 1797809222630506496 |
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| author | Debayan Guha Franz C. Mendoza-Garcia Kathryn M. Millen Joseph Offenbacher Nicholus M. Warstadt |
| author_facet | Debayan Guha Franz C. Mendoza-Garcia Kathryn M. Millen Joseph Offenbacher Nicholus M. Warstadt |
| author_sort | Debayan Guha |
| collection | DOAJ |
| description | Introduction: Wellens’ syndrome represents an important, at times overlooked, spectrum of left anterior descending (LAD) coronary artery occlusion, spontaneous reperfusion, and impending reocclusion. Once considered pathognomonic for a thromboembolic coronary event, an increasing number of clinical scenarios have been demonstrated to result in pseudo-Wellens’ syndrome, each requiring unique forms of assessment and management. Case Report: We describe two clinical presentations in which myocardial bridging (MB) of the LAD led to clinical and electrophysiologic presentations of a pseudo-Wellens’ syndrome. Conclusion: These reports represent a rare cause of pseudo-Wellens’ syndrome attributed to MB of the LAD. Transient ischemia secondary to myocardial compression of the traversing LAD leads to intermittent angina and electrocardiogram changes that are typical in patients presenting with Wellens’ syndrome secondary to an occlusive coronary event. As with other previously reported pathophysiologic mechanisms that have been shown to mimic Wellens’ syndrome, myocardial bridging should be considered in patients presenting with a pseudo-Wellens’ syndrome. |
| first_indexed | 2024-03-13T06:49:18Z |
| format | Article |
| id | doaj.art-34934b334c064281a8ba7d5b59890913 |
| institution | Directory Open Access Journal |
| issn | 2474-252X |
| language | English |
| last_indexed | 2024-03-13T06:49:18Z |
| publishDate | 2023-05-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Clinical Practice and Cases in Emergency Medicine |
| spelling | doaj.art-34934b334c064281a8ba7d5b598909132023-06-07T18:52:53ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2023-05-017210.5811/cpcem.1404cpcem-7-68Myocardial Bridge of the Left Anterior Descending Artery Causing Pseudo-Wellens’ Syndrome: A Report of Two CasesDebayan Guha0Franz C. Mendoza-Garcia1Kathryn M. Millen2Joseph Offenbacher3Nicholus M. Warstadt4Albert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Medical Centers, Bronx, New YorkAlbert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Medical Centers, Bronx, New YorkAlbert Einstein College of Medicine, Department of Emergency Medicine at the Jacobi and Montefiore Medical Centers, Bronx, New YorkNew York University Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New YorkNew York University Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New YorkIntroduction: Wellens’ syndrome represents an important, at times overlooked, spectrum of left anterior descending (LAD) coronary artery occlusion, spontaneous reperfusion, and impending reocclusion. Once considered pathognomonic for a thromboembolic coronary event, an increasing number of clinical scenarios have been demonstrated to result in pseudo-Wellens’ syndrome, each requiring unique forms of assessment and management. Case Report: We describe two clinical presentations in which myocardial bridging (MB) of the LAD led to clinical and electrophysiologic presentations of a pseudo-Wellens’ syndrome. Conclusion: These reports represent a rare cause of pseudo-Wellens’ syndrome attributed to MB of the LAD. Transient ischemia secondary to myocardial compression of the traversing LAD leads to intermittent angina and electrocardiogram changes that are typical in patients presenting with Wellens’ syndrome secondary to an occlusive coronary event. As with other previously reported pathophysiologic mechanisms that have been shown to mimic Wellens’ syndrome, myocardial bridging should be considered in patients presenting with a pseudo-Wellens’ syndrome.https://escholarship.org/uc/item/9tq45130 |
| spellingShingle | Debayan Guha Franz C. Mendoza-Garcia Kathryn M. Millen Joseph Offenbacher Nicholus M. Warstadt Myocardial Bridge of the Left Anterior Descending Artery Causing Pseudo-Wellens’ Syndrome: A Report of Two Cases Clinical Practice and Cases in Emergency Medicine |
| title | Myocardial Bridge of the Left Anterior Descending Artery Causing Pseudo-Wellens’ Syndrome: A Report of Two Cases |
| title_full | Myocardial Bridge of the Left Anterior Descending Artery Causing Pseudo-Wellens’ Syndrome: A Report of Two Cases |
| title_fullStr | Myocardial Bridge of the Left Anterior Descending Artery Causing Pseudo-Wellens’ Syndrome: A Report of Two Cases |
| title_full_unstemmed | Myocardial Bridge of the Left Anterior Descending Artery Causing Pseudo-Wellens’ Syndrome: A Report of Two Cases |
| title_short | Myocardial Bridge of the Left Anterior Descending Artery Causing Pseudo-Wellens’ Syndrome: A Report of Two Cases |
| title_sort | myocardial bridge of the left anterior descending artery causing pseudo wellens syndrome a report of two cases |
| url | https://escholarship.org/uc/item/9tq45130 |
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