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Cocaine-induced pseudo-Wellens’ syndrome: a Wellens’ phenocopy
  1. Aung Naing Lin1,
  2. Sithu Lin1,
  3. Rahul Gokhroo2,
  4. Deepika Misra3
  1. 1Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA
  2. 2Department of Cardiology, The Brooklyn Hospital Center, Brooklyn, New York, USA
  3. 3Department of Cardiology, The Brooklyn Hospital Center-Mount Sinai- Beth Israel Hospital, New York, New York, USA
  1. Correspondence to Dr Sithu Lin, dr.sithulin{at}


Wellens’ syndrome represents critical occlusion of the proximal left anterior descending coronary artery. Electrocardiographic changes similar to Wellens’ wave are not exceptional to acute coronary occlusion and can also be seen in cardiac and non-cardiac conditions, such as left ventricular hypertrophy, persistent juvenile T wave, bundle branch blocks, cerebral haemorrhage, pulmonary oedema, pulmonary embolism, pheochromocytoma, Takotsubo syndrome, digitalis and cocaine-induced coronary vasospasm. Cocaine-induced pseudo-Wellens’ syndrome should be considered as one of the differentials, since cocaine is used frequently by young adults and can cause left anterior descending coronary vasospasm mimicking Wellens’ syndrome. Initiation of the beta-blocking agent in pseudo-Wellens’ syndrome as a part of acute coronary syndrome management can be disastrous. We illustrated a case of cocaine-induced pseudo-Wellens’ syndrome presented with typical chest pain associated with Wellenoid ECG.

  • arrhythmias
  • cardiovascular medicine
  • cardiovascular system
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  • Contributors ANL: was involved in the conception of the idea, manuscript preparation, patient care and assay analysis. SL: was involved in the manuscript preparation, correlative assay and interpretation. RG: was involved in the patient care and manuscript preparation. DM: was involved in the conception of the idea, patient care and proof-reading. All the authors approved the submitted manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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