History Of Present Illness : 34 Year Old Woman With A History Of Wolff Parkinson White Syndrome
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History of present illness: 34-year-old woman with a history of Wolff Parkinson White Syndrome complains of intermittent palpitations since 2005. She has had a 24-hour Holter, which was unremarkable. She came in for a follow-up visit and had an EKG done that revealed the presence of pre-excitation. The patient reports a daily sensation of palpitations that lasts for several minutes. The patient reports lightheadedness with the palpitations without syncope. The patient underwent an exercise treadmill evaluation, which showed no evidence of ischemia. The echocardiography revealed a structurally normal heart. Delta waves were noted during evaluation but resolved at higher heart rates. Wolff-Parkinson-White syndrome (WPW) is a conduction disorder of the heart that is caused by pre accessory pathway resulting in tachyarrhythmias. Kesler & Lahham (2016) state, “Approximately 0.07% of the population often presents with the chief complaint of palpitations”. A diagnosis of WPW is made in conjunction with certain characteristics. Characteristics of WPW include: a short PR interval < 0.12 second caused by a faster electrical conduction through the accessory pathway than the atrioventricular node, upsloping of the QRS and a delta wave. The delta wave is indicative of rapid ventricular depolarization caused by the rapid conduction through the accessory pathway (Kesler & Lahham, 2016, p. 469).
CEBM, Level 4
Past Medical History: In addition to her current condition the patient has a