M Palermo

Ospedale Sandro Pertini

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Stella Luscialdo

Hospital Posadas

Rosa Pedata

University of Naples Federico II

Roberto Patrizi

Ospedale Sandro Pertini

C. Commisso

Ospedale Sandro Pertini

I Liberatore

Ospedale Sandro Pertini

Antonino Granatelli

Ospedale Sandro Pertini

N Esposito

University of Milan

E Cittadini

Ospedale Sandro Pertini

Angela Dinatale

Azienda Ospedaliera Universitaria Policlinico "G. Martino"

Sabina Carrara

Sapienza University of Rome

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Ospedale Sandro Pertini

University of L'Aquila

Sapienza University of Rome

Hospital Posadas

Policlinico Casilino

Azienda Ospedaliera Universitaria Policlinico "G. Martino"

University of Naples Federico II

Azienda Sanitaria Locale Roma 3

Duke Medical Center

Durham VA Medical Center

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WELLENS SYNDROME: TIMELY RECOGNITION AND SUCCESSFUL REVASCULARIZATION

European Heart Journal Supplements (2024)

I Liberatore F Terrinoni C. Commisso Roberto Patrizi E Cittadini

Abstract Wellens syndrome is a condition characterized by clinical and instrumental signs suggestive of a critical proximal left anterior descending (LAD) coronary artery stenosis and requires early revascularization. Diagnostic criteria include T–wave changes in ECG during asymptomatic periods in patients with a history of chest pain, absence of significant cardiac enzyme movement, no ST–segment elevation, preserved R–wave, and no pathological Q waves. Early recognition of this syndrome is crucial, due to its 10–15% prevalence, allowing proper management and myocardial function recovery, avoiding potentially catastrophic outcomes. A 64–year–old male, with hypertension, undiagnosed diabetes, and family history of CAD, presented to our ER with sudden, brief chest pain radiating to the left upper limb. Similar episodes had occurred in the past week. The patient denied previous cardiovascular events and home therapy. ECG conducted by the attending cardiologist, during free chest pain period, showed biphasic T–wave in V1–V3 (a). Admission ECG resembled the ambulatory one. Lab results: Hb 14.7 g/dl, Troponin I 0.059 ng/ml (cut–off 0.034). Echocardiogram indicated distal septum akinesia. Urgent coronary angiography was performed, detecting subocclusive stenosis in the proximal–mid LAD. Successful revascularization was achieved by PTCA and implantation of 1 DES. (b) Subsequently, the patient was admitted to the Cardiac Intensive Care Unit for multiparametric monitoring. The ECG showed deeply negative T waves from V1 to V6. (c) No complications during hospitalization. Discharge ECG showed repolarization anomalies improvement. Echocardiography revealed preserved systolic function, without global or segmental anomalies in wall motion. Wellens syndrome is a manifestation of acute coronary syndrome that precedes an anterior wall MI. This condition can be identified by its characteristic T–wave patterns on ECG. Patients with this syndrome have severe LAD occlusion and require early coronary intervention. In chest pain episodes, the ECG appears normal, and troponin levels often remain within the normal range, which can potentially provide false reassurance. Wellens syndrome is a cardiac emergency requiring immediate attention; it is crucial for the physician to promptly identify the typical ECG signs of Wellens Syndrome, facilitating early coronary revascularization to prevent adverse patient outcomes.

10.1093/eurheartjsupp/suae036.468

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OGP 6356 Cerebral/umbilical artery ratio as predictor of adverse perinatal outcome

Ultrasound in Medicine & Biology (1997)

M Palermo María Teresa Aguilar Stella Luscialdo Susana Trillo Alexandra Monaco

Umbilical artery

Perinatal mortality

10.1016/s0301-5629(97)80777-6

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Fetal lung lesions diagnosis: the crucial role of ultrasonography.

PubMed (2009)

Rosa Pedata M Palermo Monica R. Maiello N Esposito Santina Ermito

Fetal lung lesions may cause significant effects of mass and may evolve into a non-immune hydrops and lead to the death of the fetus or the child. Treatment options for these severely affected infants are constantly evolving. The widespread use of ultrasound in prenatal diagnosis, in tertiary center like ours, allows us to identify the fetus, including lung lesions more 'small. Prenatal diagnosis and possible therapeutic intervention in the immediate prenatal or postnatal period has significantly changed the quality of life and the survival of fetuses and infants, especially those who were completely asymptomatic at birth.Object of our interest is the pulmonary sequestration and congenital pulmonary malformation is the second in order of frequency, with an incidence between 0.15% and 6.4% of cases.

Prenatal ultrasound

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