Understanding Wellens Syndrome: ECG Characteristics and Diagnosis Guide

Dec 28, 2024

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Learn to identify Wellens syndrome through distinct ECG features such as positive-negative T waves in leads V2-V4 and deeply negative T waves in V2-V4. This guide clarifies differences between Wellens and STEMI, emphasizing the absence of ST elevation and Q waves in Wellens syndrome.

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Understanding Wellens Syndrome: ECG Characteristics and Diagnosis Guide

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Wellens ECGs
Wellens syndrome: note the biphasic T waves (positive-negative) in leads V2-V4. Upper arrow points at the positive deflection, negative arrow points at the negative deflection.
Wellens syndrome: note the deeply negative T wave (>5 mm) in V2-V4. We also have the biphasic shape in lead V2. ST segment is

By definition, in Wellens’ syndrome, we should not have ST elevation>1 mm and no Q waves (Wellens is not a STEMI) • If you have ST elevation along with this T wave morphologythis is not Wellens, this is STEMI