Acute Chest Pain and Broad Complex Tachycardia. A Non-typical Case of Pre-excited Atrial Fibrillation

Ramon Suarez Arias, Nuria Perez Villanueva, Gustavo Iglesias Cubero, Jose Rubin Lopez

Abstract


Wolff-Parkinson-White syndrome is a common condition in the emergency department. A case is presented of a 76-year-old patient with acute chest pain and broad complex tachycardia. Despite the fact that previous and post cardioversion ECG tracings in sinus rhythm showed no signs of pre-excitation, the characteristic pattern of pre-excited atrial fibrillation (AF) is recognized and after successful DC cardioversion the patient is referred for catheter ablation of the accessory pathway. This case illustrates a non-typical presentation of the WPW syndrome, with an older patient than usual with slight signs of pre-excitation. We highlight the need for high grades of suspicion for the early recognition of pre-excited AF when attending patients with tachycardia and the obligation to know the distinctive aspects of its management for this potentially life-threatening arrhythmia.




Cardiol Res. 2011;2(4):185-188
doi: https://doi.org/10.4021/cr70e

Keywords


Broad complex tachycardia; Pre-excited atrial fibrillation; Wolff-Parkinson-White syndrome

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