de Winter electrocardiogram pattern evolving into Wellens electrocardiogram pattern in post-percutaneous coronary intervention therapy: a case report

The de Winter ECG pattern signifies transient severe coronary stenosis during episodes of chest pain. In contrast, the Wellens ECG pattern typically occurs before PCI, with its T-wave changes often appearing during pain-free intervals, indicating spontaneous coronary artery revascularization. Post-PCI, Wellens ECG changes may suggest reperfusion injury. Timely and repeated ECG monitoring in ACS patients is crucial for identifying high-risk ECG patterns and initiating urgent reperfusion therapy. However, a Wellens ECG pattern in pre-cordial leads does not invariably signify LAD occlusion or severe stenosis.