Introduction: Wellens’ syndrome is referring to a subtype of unstable angina with specific precordial T-wave changes in ECG (deeply-inverted or biphasic T waves in V2-3, having isoelectric or minimally-elevated ST segment, absence of precordial Q waves and preserved precordial R wave progression) and having a strong likelihood to develop a large anterior myocardial infarction in subsequent clinical course. Hens, the timely diagnosis of this condition is utmost important Objective: The study was mainly aimed to describe the clinical, echocardiographic and coronary angiographic characteristics of patients with Wellens’ syndrome and to follow up the patients who underwent Percutaneous Coronary Interventions (PCI). Methodology: A descriptive cross-sectional study was conducted on patients with clinical diagnosis of Wellens’ syndrome in 2017 at teaching hospital Kandy, Sri Lanka. 2D echocardiogram was carried out in all within 24 hours of admission to evaluate the Regional Wall Motion Abnormalities (RWMA) and Global and Regional Longitudinal Strain (GLS). After the initial assessment, all the patients were subjected for coronary angiogram within 24 hours of admission. Patients who had PCI amenable lesions were treated with angioplasty and stenting. All the patients were reviewed in 30th day and 90th day following PCI for cardiac death, re-infarction or having residual angina following the treatments. Results: There were 30 patients (Mean age= 56.6±9.3 years) with 60% (n=18) of males. There were 80 %,( n=24) of patients with negative cardiac Troponin I. Mean ejection fraction of the sample was 57.9±9.8%. The average global resting Regional Wall Motion Score Index (RWMSI) was 1.04±0.07 and mean resting RWMSILAD was 1.07±0.13. In the sample, peak GLS and RLSLAD at rest were - 17.8±2.9 and -18.0±2.7 respectively. Majority 70% (n=22) had critical proximal LAD stenosis which was defined as ≥90% luminal stenosis. Out of the sample, 50% (n=15) had single vessel disease involving LAD. Addition to that 16.6% (n=5) and 20% (n=6) had double and triple vessel disease respectively. All who had critical LAD stenosis underwent PCI. At the end of the 30th day and 90th day following PCI, none of them had cardiac death, re-infarction or residual angina. Conclusion: In Wellens’ syndrome, elevation of cardiac Troponin, echocardiographic parameters such as GLS or RWMSI might not enable the prediction of significant LAD stenosis. Therefore, the high degree of clinical vigilance is important to identify this condition in a timely manner.
