ECG Case 3

Question 1

HPC: Mr Jones is a 25 year old gentleman admitted to ED complaining of intermittent palpitations. He reports several episodes today of his heartbeat racing, with associated light headedness. He is currently asymptomatic.

BG: Asthma

O/E:
Obs: RR 12, Sats 99% (OA), HR 60, BP 115/78, Temp 36.3

CVS: CRT <2, HS I+II+O, Pulse regular

Resp: Clear

Answer 1

-

Question 2

This is his ECG. What are the abnormalites seen?

Answer 2

• short PR interval with δ waves
• tall R waves
• anterior T wave inversions (leads V1-V4)

Question 3

what is the dx?

Answer 3

Wolff-Parkinson-White syndrome

Question 4

what tachyarrhythmia is this dx associated with?

Answer 4

atrioventricular reentry tachycardia (AVRT)

Question 5

how do you manage this pt?

Answer 5

• no mx required in asx pts
• treat if symptomatic or high risk jobs*
• Rx:
  
  • beta blockers
  • ablation