Wellens’ Syndrome in a HIV-positive Patient: A Case Report

Pramod Theetha Kariyanna¹, Denis Yusupov¹, Benjamin Ramalanjaona¹, Apoorva Jayarangaia², Mohammed Al-Sadawi¹ and Isabel. M. McFarlane^1,

¹Division of Cardiovascular Disease and Department of Internal Medicine, State University of New York: Downstate Medical Center, Brooklyn, New York, United States-11203

²Department of Internal Medicine, NYC Health and Hospitals/Jacobi Medical Center, Bronx, N.Y., U.S.A- 10461

Cite this paper

Pramod Theetha Kariyanna, Denis Yusupov, Benjamin Ramalanjaona, Apoorva Jayarangaia, Mohammed Al-Sadawi and Isabel. M. McFarlane. Wellens’ Syndrome in a HIV-positive Patient: A Case Report. American Journal of Medical Case Reports. 2019; 7(11):297-300. doi: 10.12691/AJMCR-7-11-9

Abstract

Patients with human immunodeficiency virus (HIV) are at higher risk for coronary artery disease, due to accelerated atherosclerosis resulting from chronic inflammation, the prevalence of cardiovascular risk factors and the side effects of highly active antiretroviral therapy (HAART). The Wellens’ pattern is an electrocardiographic (ECG) finding that represents critical proximal left anterior descending (LAD) coronary artery stenosis that, that when is not promptly treated, can lead to extensive anterior wall myocardial infarction and death. Very few cases of Wellens’ syndrome in HIV positive patients have been reported. We present a case of Wellens’ syndrome in a 38-year-old male with HIV on HAART and hyperlipidemia, as his only traditional cardiovascular risk factor. Recognition of the characteristic biphasic T-waves in V2 and V3 on ECG in the setting of typical angina and elevated troponin levels directed the clinicians to proceed with an emergent cardiac catheterization and percutaneous coronary intervention with drug eluting stent placement in the proximal left anterior descending artery (LAD). Physicians should recognize Wellens’ syndrome as it indicates critical LAD stenosis requiring intervention. HIV positive patients can present with Wellens’ sign at a younger age, indicating premature coronary artery disease (CAD) in this population.

Keywords

human immunodeficiency virus, HIV, Wellens syndrome, premature coronary artery disease, biphasic T-waves, chronic inflammation, critical left anterior descending stenosis, dyslipidemia

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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