Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content +++ ECG Findings ++ Biphasic (“type A”) or deeply inverted (“type B”) T waves in V2-V4. Isoelectric or minimal elevation of the ST segment (< 1 mm). Absence of precordial Q waves. R-wave progression is preserved. +++ Pearls ++ These characteristic patterns of T-wave changes are closely associated with a subacute critical LAD artery stenosis. The changes are classically apparent on ECG after resolution of chest pain. These changes are often not associated with cardiac biomarker elevations. In the absence of ongoing pain or serial ECG changes, these patients can often be treated with urgent, rather than emergent, coronary intervention. ++ FIGURE 23.10A Wellens Waves. Wellens waves are present in the anterior leads and are indicative of a high-grade LAD lesion. (ECG contributors: Clifford L. Freeman, MD, and Nicole S. McCoin, MD.) Graphic Jump LocationView Full Size||Download Slide (.ppt) ++ FIGURE 23.10B Wellens type A, demonstrating biphasic T waves in the mid-precordial leads. These findings in the setting of suspected acute coronary syndrome strongly suggest an underlying high-grade LAD lesion. Graphic Jump LocationView Full Size||Download Slide (.ppt) ++ FIGURE 23.10C Wellens type B, demonstrating deeply inverted T waves in the mid-precordial leads. (ECG contributor: James V. Ritchie, MD.) Graphic Jump LocationView Full Size||Download Slide (.ppt) Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth