Tag Archives: geriatric medicine

Introduction Wellens’ syndrome is a pre-infarction electrocardiogram (ECG) pattern indicating critical proximal left anterior descending (LAD) stenosis and high risk of imminent acute myocardial infarction (MI). It is characterised by specific T-wave changes in precordial leads, typically biphasic or deeply inverted T-waves in V2–V3 (type B) or symmetrical deeply inverted T-waves in V1–V6 (type A).1 This pre-infarction state represents temporary stabilisation of an unstable coronary plaque.2 Current guidelines recommend urgent coronary angiography and revascularisation. However, for elderly patients with multiple comorbidities, invasive

Prognostic implications There are profound prognostic implications for those suffering from syncope – Soteriades et al., in their study, evaluated the incidence and prognosis of syncope in participants in the Framingham Heart Study.5 They found the most frequently identified causes were vasovagal syncope, cardiac syncope and orthostatic hypotension: 36% still had no demonstrable cause. There was no increased risk of cardiovascular morbidity or mortality associated with vasovagal syncope, but persons in this study who fell into the diagnostic categories of cardiac syncope or syncope of unknown cause, were at increased risk of death from any