Image of the Week: Sudden onset of pounding heartbeat - Clinical Advisor

Image of the Week: Sudden onset of pounding heartbeat

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A patient presented with chest discomfort and sudden onset of heart palpitations, described as “too rapid to count.” Can you determine the cause of this patient’s abnormal heart rhythm based on this electrocardiogram.

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Figure 1.

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This patient has Wolff-Parkinson-White Syndrome (WPW). The etiology of her arrhythmia can be mapped to the slowed, slurred upstroke on the R-wave. This slow depolarization, also known as preexcitation, is manifested on ECG as a delta wave, and is pathognomonic...

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This patient has Wolff-Parkinson-White Syndrome (WPW). The etiology of her arrhythmia can be mapped to the slowed, slurred upstroke on the R-wave. This slow depolarization, also known as preexcitation, is manifested on ECG as a delta wave, and is pathognomonic of a bypass-tract mediated reentry tachycardia.


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