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Pseudo-Wellens’ syndrome secondary to concurrent cannabis and phencyclidine intoxication
  1. Faisal Inayat1,
  2. Iqra Riaz2,
  3. Nouman Safdar Ali1,
  4. Vincent M. Figueredo3
  1. 1Allama Iqbal Medical College, Lahore, Pakistan
  2. 2Einstein Medical Center, Philadelphia, Pennsylvania, USA
  3. 3Institute for Heart and Vascular Health, Einstein Medical Center, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Faisal Inayat, faisalinayat{at}


Wellens’ syndrome is an electrocardiographic pattern of T-wave changes associated with critical stenosis of the proximal left anterior descending artery, signifying imminent risk of an anterior-wall myocardial infarction. The Wellens’ electrocardiographic pattern can also be noted in several cardiac and non-cardiac diseases. We chronicle here a unique case of a patient who presented with atypical left chest pain and dizziness for 6 hours. His pain started after he smoked phencyclidine-laced cannabis. Cardiac panel demonstrated normal troponin T levels. Electrocardiogram showed sinus rhythm with new deep biphasic T-wave inversions in anterolateral leads. Coronary angiography showed no pathological processes. Subsequently, ECG changes resolved coincidentally with the resolution of chest pain. He was eventually diagnosed with pseudo-Wellens’ syndrome. This paper illustrates that physicians should be vigilant for Wellens’ syndrome mimicked by acute phencyclidine and cannabis intoxication. Additionally, we present a review of various aetiologies of pseudo-Wellens’ syndrome, especially in patients with substance abuse.

  • arrhythmias
  • cardiovascular medicine
  • cardiovascular system

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  • Contributors FI: designed the study, performed the literature review, drafted the manuscript and reviewed the manuscript. IR: contributed to the case presentation. NSA: contributed to the discussion. VMF: revised the manuscript critically for important intellectual content and gave the final approval for the version published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

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