![]() However, it is safer to assume the worst (i.e. with RCA or circumflex occlusion.Īlso, the inciting event does not necessarily have to be thrombus formation - Wellens syndrome may also occur in normal coronary arteries following an episode of vasospasm, as in this case of cocaine-induced vasospasm. ![]() This sequence of events is not limited to the anterior leads - similar changes may be seen in the inferior or lateral leads, e.g. This would manifest as alternating ECGs demonstrating Wellens and pseudonormalisation/STEMI patterns
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