Wolff Parkinson White

Question 1

What is AVRT?
What does it stand for?

Answer 1

Atrioventricular reentrant tachy

Means an accessory pathway exists for impulse conduction, not through AVN, connects atria + ventricles
‘backdoor entrance therefore no delay

Question 2

Genetic or environmental?

Answer 2

often hereditary

Question 3

MC example ?

Answer 3

WPW; accessory pathway for conduction = bundle of Kent

a pre excitation syndrome (excites ventricles eerier than typical pathway; this is why you see delta waves)

Question 4

Sx?

Answer 4

palpitations, dyspnoea, dizziness

Question 5

Dx?

Answer 5

ECG
shortened PR interval
slurred delta wave
Wide QRS complex

Question 6

Tx?
1st, 2nd and 3rd

Answer 6

1. Valsalva maneuver (blow into syringe, vs resistance)
   carotid massage
2. IV adenosine (will temporarily cease conduction, warn patient ‘feel like dying’ - 6mg, then 12mg then further 12mg (additional doses if 6mg unsuccessful)
3. Consider surgical radio frequency ablation of bundle of Kent