A 49 years old male recently diagnosed as a case of diabetes mellitus came to JIPMER, Pondicherry, India with chief complaints of one episode of palpitation 10 20 days back, which was acute in onset, long lasting associated with giddiness and perspiration. There was no history of syncope, chest pain or vomiting. Patient went to private hospital, ECG done which was suggestive of tachycardia which was relived with intravenous injection. During evaluation in the JIPMER cardiology OPD, patient Pulse was 86 per minute, BP-110/80, Cardiovascular and Respiratory system was normal.
ECG during tachycardia (Click on the image to enlarge it)
Description of the ECG-Narrow QRS complex tachycardia with rate around 200 beats per minute, normal axis, clearly visible P waves not visible, T wave inversion in lead 2,3,avF,V5,V6, so the impression from this ecg is short RP narrow QRS tachycardia.
Sinus ECG of the patient
Description of the ECG-Normal sinus rhythm at 75 beats per minute, LAD, Kindly see PR inteval in lead II, PR interval is 0.4 sec (40 msec), there is delta wave seen, Delta wave are postive in lead I, II, V2-V6, Negative Delta wave seen in lead III, avF, V1, Early transition from lead V1 to lead V2
More ECG of the same patient
Sinus ECG of the patient
Sinus ECG of the patient
Diagnosis of the patient is WPW syndrome with right posterosetapl pathway
Approach in a patient with Short RP tachycardia
Localisation of pathway in a patient with WPW syndrome
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