Wellens Syndrome Differential Diagnoses

Updated: Jan 25, 2018
  • Author: Benjamin B Mattingly, MD; Chief Editor: Erik D Schraga, MD  more...
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Diagnostic Considerations

Potential diagnostic pitfalls with Wellens syndrome include the following:

  • Failing to recognize Wellens syndrome T-wave changes on electrocardiography (ECG)

  • Ordering a stress test without recognizing risks (see Workup); this may provoke a large anterior wall myocardial infarction (MI) [3]

  • Underestimating the seriousness of the ECG finding in a pain-free patient

  • Failing to properly admit or consult cardiology on patients with the characteristic ECG changes

In addition to the conditions listed in the differential diagnosis (see below), other conditions to be considered include the following:

  • Central nervous system injury

  • Persistent juvenile T-wave pattern

  • Left ventricular hypertrophy

  • Bundle-branch block

  • Digitalis effect

  • Acute myocarditis

  • Preexcitation syndromes

  • Later stages of pericarditis

Differential Diagnoses