RESUMEN
Wellens syndrome is a precursor of left anterior descending (LAD) coronary stenosis. It is characterized by biphasic T waves in V2-V3 (type A) or negative deep T waves in V2-V4 (type B). The ability of emergency physicians, hospitalists, or primary care providers to recognize these early ECG patterns is primordial because the definitive treatment is urgent cardiac catheterization with percutaneous coronary intervention. However, failure to identify a type A or type B Wellens syndrome may lead to devastating outcomes, such as myocardial infarction or even death. We presented a clinical case of Wellens' syndrome with deep T waves in V2-V3 associated with COVID pneumonia, pleural effusions, and congestive heart failure that went to a rapid and massive myocardial infarction.
RESUMEN
Congenital absence of the left main coronary artery is a very rare entity. The literature surrounding this presentation describes it as a fairly common cause of sudden death especially in early life. Some schools of thought hypothesize that for the few cohorts who live into their adulthood with this anomaly, serious cardiovascular complications usually ensue. We present a case of a generally healthy and asymptomatic 67-year-old gentleman with a history of diagnosed congenital absence of the left main coronary artery since age six without any active cardiovascular complaints at baseline.