WPW 1

WPW case 1. (With R/S >1)

Patient. 55 year old male was admitted with clinical picture consistent with unstable angina. He underwent a successful stent placement of the near occluded distal right coronary artery lesion. He has WPW patern on ECG. There has been no documentation of tachyarrhythmia in this patient. There is no relationship between his coronary artery disease and the WPW syndrome.

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III

Characteristic:
• Ventricle is excited through the accessory pathway sooner than normally excited through the normal conduction pathway, creating: (1) short PR interval (<120 ms), (2) Wide QRS, begin with Delta wave, (3) Abnormal (secondary) repolarization.
Other findings:
• Ventricular preexcitation may produce pseudo (infarction) Q wave (4), case 2.
• Ventricular preexcitation may produce abnormal QRS voltage, abnormal axis on frontal plane (LAD in case 2 and RAD in case 4), and abnormal QRS direction in precordial leads. (5) Predominant R wave in V1 (R/S ratio >1 in V1) in case 1 and case 4.
• Repolarization change may mask other cause of abnormal repolarization.
• May display varying degree of preexcitation, observed in the same patient. (Case 2 and Case 3)

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Go to predominant R wave in V1 (R/S ratio >1).
Go to axis deviation. Go to pseudo (infarction) Q wave.
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WPW case 1. (With R/S >1)
Patient. 55 year old male was admitted with clinical picture consistent with unstable angina. He underwent a successful stent placement of the near occluded distal right coronary artery lesion. He has WPW patern on ECG. There has been no documentation of tachyarrhythmia in this patient. There is no relationship between his coronary artery disease and the WPW syndrome.
II III	Characteristic: • Ventricle is excited through the accessory pathway sooner than normally excited through the normal conduction pathway, creating: (1) short PR interval (<120 ms), (2) Wide QRS, begin with Delta wave, (3) Abnormal (secondary) repolarization. Other findings: • Ventricular preexcitation may produce pseudo (infarction) Q wave (4), case 2. • Ventricular preexcitation may produce abnormal QRS voltage, abnormal axis on frontal plane (LAD in case 2 and RAD in case 4), and abnormal QRS direction in precordial leads. (5) Predominant R wave in V1 (R/S ratio >1 in V1) in case 1 and case 4. • Repolarization change may mask other cause of abnormal repolarization. • May display varying degree of preexcitation, observed in the same patient. (Case 2 and Case 3)