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Feinstein MJ, Bahiru E, Achenbach C, Longenecker CT, Hsue P, So-Armah K, Freiberg MS, Lloyd-Jones DM. Patterns of cardiovascular mortality for HIV-infected adults in the United States: 1999 to 2013. The American journal of cardiology. 2016 Jan 15; 117(2): 214-20.

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Article

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

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


American Journal of Medical Case Reports. 2019, Vol. 7 No. 11, 297-300
DOI: 10.12691/ajmcr-7-11-9
Copyright © 2019 Science and Education Publishing

Cite this paper:
Pramod Theetha Kariyanna, Denis Yusupov, Benjamin Ramalanjaona, Apoorva Jayarangaia, Mohammed Al-Sadawi, 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.

Correspondence to: Isabel.  M. McFarlane, Division of Cardiovascular Disease and Department of Internal Medicine, State University of New York: Downstate Medical Center, Brooklyn, New York, United States-11203. Email: Isabel.McFarlane@downstate.edu

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.

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