intermittent typical angina: remember wellens' syndrome

Introduction: we describe a patient without a history of cardiovascular diseases as an example of wellens’ syndrome (ws).case report: a 65-year-old man presented to emergency department due to intermittent chest pain. physical examination and chest x-ray were unremarkable. electrocardiogram (ecg) showed biphasic t-wave in precordial leads v1-v4. primary cardiac serum biomarkers including high-sensitive cardiac troponin t (hs-ctnt) and ck-mb were slightly elevated, that further assessment did not show any increases; while ecg recorded during a pain period revealed t-wave pseudo-normalization. the patient underwent coronary angiography that revealed a proximal left anterior descending artery lesion.conclusion: ws is a diagnostic and management challenge and serial ecg evaluation is still essential for a possible acute coronary syndrome. having knowledge of all subtle features of this syndrome, could avoid improper discharge of high-risk patients. definitely, accurate risk stratification, and prompting these patients to an early coronary angiogram and treatment are mandatory to avoid development of a massive anterior myocardial infarction.