• Julio C Rotondaro, Mauricio Delgado Gaete, Gonzalo Fernandez Villar, Pilar Domenech, Constanza Bezazian, and Rodolfo Pizarro.
• Servicio de Clínica Médica,Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina. E-mail: rotondarojuliocesar@gmail.com.
• Medicina (B Aires). 2022 Jan 1; 82 (5): 787-790.

AbstractWe present the case of a 40-year-old male without cardiovascular risk factors, who was admitted to our hospital due to chest pain. The electrocardiogram showed a typical pattern, already described, known as Wellens syndrome type 1 or A, characterized by ST segment elevation <1 mm and biphasic T wave in lead V3. Was diagnosed of acute myocardial infarction without ST elevation, TIMI 3 and GRACE score 66 points. This electrocardiographic pattern is of high risk, beyond the stratifying scores, since it correlates with severe injury to the anterior descending artery at the proximal level and requires percutaneous intervention without delay. The coronary angiography revealed 3 severe lesions: the proximal and middle thirds of the left anterior descending artery and the first diagonal. We highlight the validity of this electrocardiographic pattern, described more than 40 years ago, to identify and stratify patients with acute coronary syndrome.

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