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Myocardial infarction in a patient with WPW syndrome. Lifting the veil

Vickram Vignesh Rangaswamy1, Akshay Balaji1, Sakthivel Ramasamy2

  • 1Department of Cardiology, Sri Ramakrishna Hospital, Coimbatore, India.

Journal of Electrocardiology
|September 2, 2022
PubMed

Insights

Wolf-Parkinson-White syndrome can mimic myocardial infarction. Specific ECG findings like delta-T wave concordance and QRS fragmentation helped identify myocardial infarction onset in a patient with WPW syndrome.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Diagnostics

Background:

  • Wolf-Parkinson-White (WPW) syndrome is characterized by abnormal electrical conduction in the heart.
  • Repolarization changes in WPW syndrome can obscure the diagnosis of other cardiac conditions.
  • Myocardial infarction (MI) diagnosis relies on characteristic electrocardiographic (ECG) findings.

Observation:

  • A patient with WPW syndrome presented with symptoms suggestive of myocardial infarction.
  • The typical ECG features of MI were masked by the underlying WPW abnormality.
  • Atypical ECG features were noted, posing a diagnostic challenge.

Findings:

  • The study identified specific ECG markers, delta-T wave concordance and QRS fragmentation, indicative of MI onset in WPW syndrome.
  • These findings highlight the potential for WPW to mask acute MI.
  • Early recognition of these subtle ECG changes is crucial.

Implications:

  • This case emphasizes the importance of considering MI in patients with WPW syndrome, even with atypical ECG presentations.
  • Awareness of these specific ECG findings can expedite MI diagnosis in WPW patients.
  • Improved diagnostic strategies are needed for concurrent WPW and MI.
Keywords:
Myocardial infarctionPreexcitationPseudoinfarctQRS fractionationRepolarizationWPW syndrome

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