Diagnostic Skills Challenge
We have described an actual scenario below. Can you figure out the correct diagnosis?
27 Year-Old Female With Episodes Of Palpitations
A 27-year-old female presents complaining that “my heart pounds” several times a day lately. She states that these episodes started when she was a senior in high school. She decided to seek medical care because of the increased frequency of these events. She states that she has never become dizzy, confused nor lost consciousness when the palpitations occur. There is no significant past or present medical history. Her BP is 112/66, heart rate 88. She denies taking any medications. The 12-lead ECG is done and displayed on the right.
What is your diagnosis?Show Diagnosis Hide Diagnosis
The diagnosis is:
- Short PR interval, less than 3 small squares (120 ms)
- Slurred upstroke to the QRS indicating pre-excitation (delta wave)
- Broad QRS
- Secondary ST and T wave changes
Localizing the Accessory Pathway
An accessory pathway, bundle of Kent, exists between atria and ventricles and causes early depolarization of the ventricle. The location of the pathway may be deduced as follows:
|Left Posteroseptal (Type A)||+ve||+ve||Left|
|Right Lateral (Type B)||-ve||-ve||Left|
|Left Lateral (Type C)||+ve||+ve||Inferior (90 degrees)|