Wolff-Parkinson-White syndrome - NYSORA

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Wolff-Parkinson-White syndrome

Learning objectives

  • Describe the mechanisms & symptoms of Wolff-Parkinson-White Syndrome 
  • Manage patients with Wolff-Parkinson-White Syndrome 

Definition & mechanisms

  • Wolff-Parkinson-White Syndrome (WPW) is a congenital abnormality that involves the presence of abnormal electrical conductive circuits between the atria and ventricles, resulting in accessory electrical pathways that bypass the AV node
  • Can result in life-threatening arrhythmias

Signs & symptoms

Electrocardiographic signsShort PR interval
Prolonged QRS
Initial slurring upstroke (“delta” wave) in the presence of sinus rhythm
Clinical symptoms
Palpitations
Episodic lightheadedness
Presyncope
Syncope
Cardiac arrest

Management

Wolff-parkinson-white, wpw, palpitations, syncope, dyspnea, angina, halothane, megeridine, pancuronium, atracurium, succinylcholine, ketamine, neostigmine, glycopyrolate, atropine, ephedrine, epinephrine, isoproterenol, metoclopramide, defibrillator, orthodromic antidromic atrioventricular tachycardia, carotid massage, valsalva, adenosine, verapamil, procainamide, amiodarone, cardioversion, resuscitation

Suggested reading

  • Bengali R, Wellens HJ, Jiang Y. Perioperative management of the Wolff-Parkinson-White syndrome. J Cardiothorac Vasc Anesth. 2014;28(5):1375-1386.

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