Wolf parkinsons white syndrome6/2/2023 3 In rare cases, WPW can lead to sudden cardiac death presumably because of ventricular fibrillation. Symptoms of tachycardia include palpitations, dizziness, fatigue, shortness of breath, and loss of consciousness. 1 It is caused by an extra, accessory atrioventricular conduction pathway in which impulses get caught in a circular conduction pattern, travelling around the heart at an increased rate. A repeat ECG showed normal results after a catheter ablation was performedĭiscussion. WPW syndrome is a congenital electrical abnormality of the heart typically associated with supraventricular tachycardia. The patient had no further symptoms.įigure 2. At this time catheter ablation was performed, and repeat ECGs returned normal results (Figure 2). One month later, at a follow-up visit, an electrophysiologic study (EPS) was conducted, results of which revealed a left anterolateral accessory pathway. However, the patient and his parents were hesitant to start a β-blocker agent, as this would interfere with his athletic endeavors. The cardiologist recommended discontinuing vigorous exercise and initiating a β-blocker agent. An ECG revealed the presence of a delta wave, a prolonged QRS interval, and a shortened PR interval. Results of a 24-hour Holter monitor and an echocardiography scan were normal.įigure 1. The delta wave persisted during the test, and no arrhythmia was induced. 2 A 12-lead ECG was connected for the duration of the test. Each stage lasts 3 minutes, and total duration is adjusted to the patient's tolerance. The test requires patients to walk or run at progressively faster and steeper gradients. The patient was referred to a cardiologist, where a treadmill stress test was conducted to assess the refractory period of the accessory pathway. The differential diagnosis included cardiac, endocrine, and pulmonary disorders and recreational drug use (Table 1).Īn electrocardiography (ECG, Figure 1) scan revealed the presence of a delta wave, a prolonged QRS interval of 150 ms (abnormal reference range, > 120 ms), and a shortened PR interval of 110 ms (abnormal reference range, < 120 ms) 1, which fulfilled the criteria for Wolff-Parkinson-White (WPW) syndrome. There was no family history of heart disease or sudden death. He denied syncope and consumption of caffeinated beverages. Each episode had lasted approximately 5 minutes, causing him to feel exhausted and dizzy. These episodes were described as an “unsteadiness in the heart,” beginning with a few seconds of an irregular rhythm followed by 1 to 2 minutes of a speeding heartbeat. He was an athlete and had experienced 4 such episodes in 7 months-3 had occurred during physical exertion and 1 at rest. McGovern Medical School, University of Texas, Houston, 6410 Fannin Street #1014, Houston, TX 77030 ( 13-year-old boy presented with his parents to his general practitioner with a skipping heartbeat, shortness of breath, dizziness, and chest pressure. The authors report no relevant financial relationships. Accepted August 2, 2021. Published online November 19, 2021.īrendan Saunders and Miriam Matthews contributed equally to this article. Wolff-Parkinson-White syndrome in a young athlete. Saunders B, Matthews M, Mazur L, El Kadri M. McGovern Medical School, University of Texas, HoustonģSheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates 1University College Dublin, Dublin, IrelandĢJohn P.
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