Wolf Parkinson White Flashcards
Define WPW?
A congenital abnormality which can result in supraventricular tachycardias that use an accessory pathway. It is a pre-excitation syndrome.
Pre-excitation syndrome: early activation of the ventricles due to impulses bypassing the AV node via an accessory pathway.
what is the name of the accessory pathway in WPW?
Bundle of kent- likely congenital
what are the risk factors for WPW?
Congenital cardiac defects
Ebstein’s anomaly (congenital malformation of the heart characterised by displacement of septal and posterior tricuspid leaflets)
Mitral valve prolapse
Cardiomyopathies (e.g. HOCM)
Summarise the epidemiology of WPW?
Relatively COMMON
Most common of the ventricular pre-excitation syndromes
Found in ALL AGES
More common in the YOUNG
Prevalence decreases with age
What are the presenting symptoms and signs of WPW?
SVT may occur in early childhood
often asymptomatic- may be an incidental finding as an ECG
- palpitations
- light headidness
- syncope
paroxysmal SVT may be followed by a period of polyuria, due to atrial dilatation and release of ANP
sudden death- if SVT deterioraites into VF
clinical features are associated cardiac defects ( mitral valve prolapse)
what are the classic ECG findings in WPW syndrome?
short PR interval
Broad QRS complex
slurred upstroak in intitial portion of QRS producing a delta wave this is because the ventricles are being excited over a long period of time
NEED A DELTA AND TACHY
What are the appropriate investigations for WPW?
ECG
bloods- check the cause for arrythmia
treadmil exercise test
Echo- structural heart defects
- coronary artery disease
- cardiomyopathy
- vavlular disasse
- long QT syndrome
- Brugada syndrome
