Wolff-Parkinson-White syndrome diagnosis overview: Difference between revisions
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==Overview== | ==Overview== | ||
The diagnose of WPW pattern is commonly made by an incidental [[electrocardiogram|ECG]] finding in an [[asymptomatic]] individual. The characteristic [[EKG]] finding is a [[delta wave]], which represents the pre-excitation of the [[ventricles]] through the [[accessory pathway]]. The delta wave is an upstroke in the R wave of the QRS complex that is associated with a short PR interval. | The diagnose of WPW pattern is commonly made by an incidental [[electrocardiogram|ECG]] finding in an [[asymptomatic]] individual. The characteristic [[EKG]] finding is a [[delta wave]], which represents the pre-excitation of the [[ventricles]] through the [[accessory pathway]], this phenomenon presents because the [[AV node]] has the property of slowing the impulses, therefore the the conduction throuhg the [[accessory pathway]] is faster, therefore the [[ventricles]] are excited through two different pathways. The [[delta wave]] is an upstroke in the R wave of the QRS complex that is associated with a short PR interval. [[Delta waves]] are only present when the patient is in sinus rythm, when tachycardia starts the delta wave is no longer pressent. | ||
Patients WPW syndrome with episodes of atrial fibrillation will present ECG with rapid polymorphic wide-complex tachycardia.<ref name="Fengler-2007">{{Cite journal | last1 = Fengler | first1 = BT. | last2 = Brady | first2 = WJ. | last3 = Plautz | first3 = CU. | title = Atrial fibrillation in the Wolff-Parkinson-White syndrome: ECG recognition and treatment in the ED. | journal = Am J Emerg Med | volume = 25 | issue = 5 | pages = 576-83 | month = Jun | year = 2007 | doi = 10.1016/j.ajem.2006.10.017 | PMID = 17543664 }}</ref> This combination of atrial fibrillation and WPW is considered dangerous as a high risk of [[ventricular fibrillation]] is present. [[AV node]] blocking agents ar contraindicated in this patients because it will enhance the conduction through the [[accessorry pathway]]. | |||
Patients with WPW often exhibit more than one accessory pathway, and in some patients as many as eight additional abnormal pathways can be found. This has been seen in individuals with [[Ebstein's anomaly]]. | Patients with WPW often exhibit more than one accessory pathway, and in some patients as many as eight additional abnormal pathways can be found. This has been seen in individuals with [[Ebstein's anomaly]]. | ||
Revision as of 16:13, 14 April 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
The diagnose of WPW pattern is commonly made by an incidental ECG finding in an asymptomatic individual. The characteristic EKG finding is a delta wave, which represents the pre-excitation of the ventricles through the accessory pathway, this phenomenon presents because the AV node has the property of slowing the impulses, therefore the the conduction throuhg the accessory pathway is faster, therefore the ventricles are excited through two different pathways. The delta wave is an upstroke in the R wave of the QRS complex that is associated with a short PR interval. Delta waves are only present when the patient is in sinus rythm, when tachycardia starts the delta wave is no longer pressent.
Patients WPW syndrome with episodes of atrial fibrillation will present ECG with rapid polymorphic wide-complex tachycardia.[1] This combination of atrial fibrillation and WPW is considered dangerous as a high risk of ventricular fibrillation is present. AV node blocking agents ar contraindicated in this patients because it will enhance the conduction through the accessorry pathway.
Patients with WPW often exhibit more than one accessory pathway, and in some patients as many as eight additional abnormal pathways can be found. This has been seen in individuals with Ebstein's anomaly.
Wolff-Parkinson-White syndrome is sometimes associated with Leber's hereditary optic neuropathy (LHON), a form of mitochondrial disease.[2]
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One beat from a rhythm strip in V2 demonstrating characteristic findings in WPW syndrome. Note the characteristic delta wave (subtler here than in some cases), the short PR interval of 0.08 seconds, and the long QRS complex at 0.12 seconds.
References
- ↑ Fengler, BT.; Brady, WJ.; Plautz, CU. (2007). "Atrial fibrillation in the Wolff-Parkinson-White syndrome: ECG recognition and treatment in the ED". Am J Emerg Med. 25 (5): 576–83. doi:10.1016/j.ajem.2006.10.017. PMID 17543664. Unknown parameter
|month=ignored (help) - ↑ Mashima Y, Kigasawa K, Hasegawa H, Tani M, Oguchi Y. (1996). "High incidence of pre-excitation syndrome in Japanese families with Leber's hereditary optic neuropathy" (subscription required). Clinical Genetics. 50 (6): 535–7. PMID 9147893.