BMJ Case Reports 2018; doi:10.1136/bcr-2018-224582
  • Images in…

Wellens’ syndrome: a pattern to remember

  1. Bruno Cordeiro Picarra
  1. Hospital do Espirito Santo EPE, Evora, Portugal
  1. Correspondence to Dr Tiago Gama Ramires, tiago.raposo.ramires{at}
  • Accepted 1 April 2018
  • Published 10 April 2018


Electrocardiographic changes in asymptomatic individuals may be a diagnostic challenge. The knowledge and early identification of these patterns and their correct association with clinical picture shall have an urgent and specific management.

A 75-year-old Caucasian man with medical history of hypertension and peripheral arterial disease presented at the emergency department, transported by the prehospital emergency team, complaining of an intense chest pain, which woke him up, with irradiation to the left upper limb and diaphoresis. The patient denied nausea, vomiting, palpitations and previous complaints of angina as well. It was administered, during transport, sublingual nitroglycerine, with resolution of the pain.

The patient was vigil, oriented and haemodynamically stable. Physical examination was unremarkable.

The admission ECG, without pain, showed sinus rhythm, heart rate of 60 bpm, right bundle branch block pattern and …

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