Pseudo-Wellens' syndrome secondary to concurrent cannabis and phencyclidine intoxication. 2018

Faisal Inayat, and Iqra Riaz, and Nouman Safdar Ali, and Vincent M Figueredo
Allama Iqbal Medical College, Lahore, Pakistan.

Wellens' syndrome is an electrocardiographic pattern of T-wave changes associated with critical stenosis of the proximal left anterior descending artery, signifying imminent risk of an anterior-wall myocardial infarction. The Wellens' electrocardiographic pattern can also be noted in several cardiac and non-cardiac diseases. We chronicle here a unique case of a patient who presented with atypical left chest pain and dizziness for 6 hours. His pain started after he smoked phencyclidine-laced cannabis. Cardiac panel demonstrated normal troponin T levels. Electrocardiogram showed sinus rhythm with new deep biphasic T-wave inversions in anterolateral leads. Coronary angiography showed no pathological processes. Subsequently, ECG changes resolved coincidentally with the resolution of chest pain. He was eventually diagnosed with pseudo-Wellens' syndrome. This paper illustrates that physicians should be vigilant for Wellens' syndrome mimicked by acute phencyclidine and cannabis intoxication. Additionally, we present a review of various aetiologies of pseudo-Wellens' syndrome, especially in patients with substance abuse.

UI MeSH Term Description Entries
D008297 Male Males
D009543 Nifedipine A potent vasodilator agent with calcium antagonistic action. It is a useful anti-anginal agent that also lowers blood pressure. Adalat,BAY-a-1040,Bay-1040,Cordipin,Cordipine,Corinfar,Fenigidin,Korinfar,Nifangin,Nifedipine Monohydrochloride,Nifedipine-GTIS,Procardia,Procardia XL,Vascard,BAY a 1040,BAYa1040,Bay 1040,Bay1040,Monohydrochloride, Nifedipine,Nifedipine GTIS
D010622 Phencyclidine A hallucinogen formerly used as a veterinary anesthetic, and briefly as a general anesthetic for humans. Phencyclidine is similar to KETAMINE in structure and in many of its effects. Like ketamine, it can produce a dissociative state. It exerts its pharmacological action through inhibition of NMDA receptors (RECEPTORS, N-METHYL-D-ASPARTATE). As a drug of abuse, it is known as PCP and Angel Dust. 1-(1-Phenylcyclohexyl)piperidine,Angel Dust,CL-395,GP-121,Phencyclidine Hydrobromide,Phencyclidine Hydrochloride,Sernyl,Serylan,CL 395,CL395,Dust, Angel,GP 121,GP121
D010623 Phencyclidine Abuse The misuse of phencyclidine with associated psychological symptoms and impairment in social or occupational functioning. Angel Dust Abuse,PCP Abuse,Phencyclidine-Related Disorders,Abuse, Angel Dust,Abuse, PCP,Abuse, Phencyclidine,Phencyclidine Abuses,Phencyclidine Related Disorders,Phencyclidine-Related Disorder
D002188 Cannabis The plant genus in the Cannabaceae plant family, Urticales order, Hamamelidae subclass. The flowering tops are called many slang terms including pot, marijuana, hashish, bhang, and ganja. The stem is an important source of hemp fiber. Bhang,Ganja,Hashish,Hemp,Cannabis indica,Cannabis sativa,Hemp Plant,Marihuana,Marijuana,Bhangs,Cannabi,Ganjas,Hashishs,Hemp Plants,Hemps,Plant, Hemp,Plants, Hemp
D002189 Marijuana Abuse Use of marijuana associated with abnormal psychological, social, and or occupational functioning. Cannabis Abuse,Cannabis Dependence,Cannabis-Related Disorder,Hashish Abuse,Marijuana Dependence,Marihuana Abuse,Abuse, Cannabis,Abuse, Hashish,Abuse, Marihuana,Abuse, Marijuana,Cannabis Related Disorder,Dependence, Cannabis,Dependence, Marijuana,Disorder, Cannabis-Related
D002637 Chest Pain Pressure, burning, or numbness in the chest. Precordial Catch,Precordial Catch Syndrome,Texidor's Twinge,Chest Pains,Pain, Chest,Pains, Chest,Syndrome, Precordial Catch,Texidor Twinge
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013577 Syndrome A characteristic symptom complex. Symptom Cluster,Cluster, Symptom,Clusters, Symptom,Symptom Clusters,Syndromes

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