medigraphic.com
ISSN 1810-2352 (Print)

2017, Number 2

<< Back Next >>

Rev Cub Med Int Emerg 2017; 16 (2)

Wolff Parkinson White Syndrome: a case report

Betancourt RGL, Betancourt BGJ, González PÁA

Language: Spanish
References: 30
Page: 48-56
PDF size: 412.64 Kb.


ABSTRACT

Background: prevalence of Wolff Parkinson White syndrome (WPWS) ranges from 0.1% to 3% being the most frequent pre excitation syndrome, and it is a common cause of rapid heart rate. WPWS, a pre excitation syndrome of the heart ventricles, is a congenital heart abnormality because of an anomalous beam, the Kent's Beak, which runs through the anterolateral part of the atrium and right ventricle (if it is on the left side it is called the Ohnell Beam).
Objective: to present a clinical case of a woman patient with the diagnosis of Wolff Parkinson White Syndrome and the antecedent of an Ebstein anomaly.
Clinical Case: a 47-year-old white female patient who had been diagnosed in childhood an Ebstein anomaly and a double excretion renal system as well as a 28-year-old daughter with Wolff Parkinson White syndrome diagnosed when she was 15 years old is presented. About 2 years ago the patient started with episodes of tachycardia, dizziness, difficulty breathing at times as well as feeling faint. A physical examination is performed along with the clinical picture and ECG, confirming the diagnosis of Wolff Parkinson White syndrome.
Conclusions: clinical manifestations accompanied by electrocardiographic classic data: PR interval less than 120 msec, wide QRS with delta wave and secondary changes of repolarization confirmed the diagnosis of a WPWS.


REFERENCES

  1. 1- Almendral J, Castellanos E, Ortiz M. Taquicardias paroxísticas supraven-triculares y síndromes de pre excita-ción. Rev Esp Cardiol. 2012; 65 (5) :456-69.

  2. 2- Cohen M, Triedman J, Cannon B, Davis A, Drago F, Janousek J, et al. PACES/HRS Expert Consensus Sta-tement on the Management of the Asymptomatic Young Patient with a Wolff-Parkinson-White (WPW, Ventri-cular Preexcitation) Electrocardiogra-phic Pattern. Heart Rhythm. 2012;9: 1006-24.

  3. 3- Gollob MH, Green MS, Tang A, Gollob T, Karibe A, Hasan AS y col. Identification of a gene responsible for familial Wolff–Parkinson-White syndrome. N Engl J Med 2001;344 (24):1823-1831.

  4. 4- Munger TM, Packer DL, Hammill SC, Feldman BJ, Bailey KR, Ballard DJ, et al. A population study of the natural history of Wolff-Parkinson-White Syndrome in Olmsted County, Mine-ssota, 1953-1989. Circulation 1993; 87: 866-73.

  5. 5- Viñolas Prat X, Rodriguez Font E, Alegret Colome JM, Bayés de Luna A. Arritmias hiperactivas supraventricu-lares. Medicine (Idepsa) 1996; 7(19): 762-70.

  6. 6- Castellano Reyes C, Pérez de Juan Romero MA, Espinosa Caliani JS. Síndromes de preexcitación. En: Castellanos Reyes C, Pérez de Juan Romero MA. Electrocardiografía Clíni-ca. Madrid: Ediciones Harcourt, 2000; 81-100.

  7. 7- Deal BJ, Keana JF, Gillette PC, Garson A Jr. Wolff-Parkinson-White syndrome and supraventricular tachycardia during infancy: Mana-gement and follow-up. J Am Coll Cardiol 1985; 5(1):130-5.

  8. 8- Chen SA, Chiang CE, Tai CT, Lee SH, Chiou CW, Ueng KC, et al. Longitudinal clinical and electrophy-silogical assessment of patients with symptomatic Wolff-Parkinson-White Syndrome and atrioventricular node reentrant tachycardia. Circulation 1996; 93: 2023-32.

  9. 9- L. Wolff, J. Parkinson, P. D. White. Bundle-branch block with short P-R interval in healthy young people prone to paroxysmal tachycardia. American Heart Journal, St. Louis, 1930, 5: 685.

  10. 10- Monqaut C, Serra C. Los trastor-nos de la conducción intraventricular, bloqueos de rama y síndromes de preexcitación. En: Serra C, Fuenzalida F. El electrocardiograma en la práctica médica. 2nd ed. Buenos Aires: editorial Atlante Ar-gentina SRL,1991: 38-50.

  11. 11- Almendral J, Castellanos E, Ortiz M. Update: Arrhytmias (V). Paroxysmal supraventricular tachycardias and preexcitation syndromes. Rev Esp Cardiol. 2012;65: 456-69.

  12. 12- Bayes de Luna A. Electrocardio-grafía clínica. 7.a ed. Barcelona: Permanyer; 2012; p. 209-20.

  13. 13- Rosner MH, Brady WJ Jr, Kefer MP, Martin ML. (1999). Electro-cardiography in the patient with the Wolff-Parkinson-White syndrome: diagnostic and initial therapeutic issues. American Journal of Emer-gency Medicine 17 (7): pp.705-14.

  14. 14- Olgin JE, Zipes DP. Specific arrhythmias: diagnosis and treat-ment. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's heart disease: a textbook of cardiovascular medicine. 9th ed. St. Louis, Mo: WB Saunders; 2011: chap 39.

  15. 15- Zimetbaum P. Cardiac arrhyth-mias with supraventricular origin. In: Goldman L, Schafer AI, eds. Cecil medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011 chap 64.

  16. 16- Packer DL, Gallagher JJ, Prystowsky EN. Physiologic substrate for antidromic reciprocating tachycar-dia: prerequisite characteristics of the accessory pathway and AV conduction system. Circulation 1992; 85(2): 574-88.

  17. 17- Bardy GH, Packer DL, German LD, Gallagher JJ. Preexcited recipro-cating tachycardia in patients with Wolff-Parkinson-White Syndrome: incidence and mechanisms. Circu-lation 1984; 70(3): 377-91

  18. 18- Atie J, Brugada P, Brugada J, Smeets JL, Cruz FS, Peres A, et al. Clinical and electrophysiologic characteristics of patients with anti-dromic circus movement tachycardia in the Wolff-Parkinson-White Syn-drome. Am J Cardiol 1990; 66(15):1082-91.

  19. 19- Wellens HJ, Durrer D. Wolff-Parkinson-White Syndrome and atrial fibrillation. Am J Cardiol 1974; 34(7): 777-82.

  20. 20- Lesaka Y, Yamane T, Takahashi A, Goya M, Kojima S, Soejima Y, et al. Retrograde multiple and multifiber accessory pathway conduction in the Wolff-Parkinson-White Syndrome: potential Precipitating factor of atrial fibrillation. J Cardiovasc Electro-physiol 1998; 9: 141-51.

  21. 21- Teo WS, Klein GJ, Guiraudon GM, Yee R, Leitch JW, McLellan D, et al. Multiple accessory pathways in the Wolff-Parkinson-White Syndrome as a risk factor for ventricular fibrillation. Am J Cardiol 1991; 68: 889-91 .

  22. 22- Leitch JW, Klein GJ, Yee R, Leather RA, Kim YH. Syncope associated with supraventicular tachycardia rate or vasomotor response. Circulation 1992; 85(3): 1064-71.

  23. 23- Kapoor WN. Syncope. N Eng J Med 2000; 343(25): 1856-62

  24. 24- Epstein AE, Miles WM, Benditt DG, Camm AJ, Darling EJ, Friedman PL, et al. Personal and public safety issues related to arrythmias that may affect consciousness: implications for regulation and physician recom-mendations. A medical/ scientific statement from the AHA and the NASPE. Circulation 1996; 94: 1147- 66.

  25. 25- Klein GJ, Prystowsky EN, Yee R, Sharma AD, Laupacis A. Asymp-tomatic Wolff Parkinson White: should we intervene? Circulation 1989; 80: 1902-5.

  26. 26- García Civera R. Electrofisiología de las vías accesorias AV comunes. En: García Civera R, Ruiz Granell R, MorellCabedo S, Sanjuán Máñez R, Martínez Leon J, Botella Solana S, et al. Electrofisiología Cardíaca Clínica y Ablación. Madrid: McGraw-Hill-Interamericana, 1999; 181-203.

  27. 27- Almendral Garrote J, MarínHuerta E, Medina Moreno O, Peinado Peinado R, Pérez Álvarez L, Ruiz Granell R, et al. Guías de práctica clínica de la Sociedad Española de Cardiología en arritmias cardíacas. Rev Esp Cardiol 2001; 54: 307-67.

  28. 28- Jung Jung H, Young Ju H, Chul Hyun M, Bum Lee S, Hyang Kim Y. Wolff-Parkinson-White syndrome in young people, from childhood to young adulthood: relationships between age and clinical and electrophysiological findings. Korean J Pediatr. 2011;54(12):507-11.

  29. 29- Cain N, Irving C, Webber S, Beerman L, Arora G. Natural History of Wolff-Parkinson-White Syndrome Diagnosed in Childhood. Am J Cardiol 2013; 112(7):961-5.

  30. 30- Pappone C, Videdomini G, Man-guso F, Baldi M, Pappone A, Petretta A, et al. Risk of Malignant Arrhyth-mias in Initially Symptomatic Patients With Wolff-Parkinson-White Syndrome Results of a Prospective Long-Term. Electrophysiological Follow Up Study. Circulation. 2012;125:661-8.




2020     |     www.medigraphic.com