What are the differential diagnoses for Wolff-Parkinson-White (WPW) syndrome?

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Last updated: May 9, 2025View editorial policy

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Differential Diagnoses for Wolff-Parkinson-White (WPW) Syndrome

Single Most Likely Diagnosis

  • Atrial Fibrillation with Anterograde Conduction Down an Accessory Pathway: This is the most likely diagnosis in patients presenting with WPW syndrome, as it is a common manifestation of the condition. The presence of an accessory electrical pathway in the heart can cause the heart to beat too quickly, leading to atrial fibrillation.

Other Likely Diagnoses

  • Paroxysmal Supraventricular Tachycardia (PSVT): PSVT is another common presentation of WPW syndrome, where the accessory pathway can cause a rapid heart rate that starts in the upper chambers of the heart.
  • Orthodromic Atrioventricular Reentrant Tachycardia (OAVRT): OAVRT is a type of supraventricular tachycardia that can occur in patients with WPW syndrome, where the accessory pathway is used for retrograde conduction.
  • Atrial Flutter with Variable Block: Atrial flutter is a type of arrhythmia that can occur in patients with WPW syndrome, where the accessory pathway can cause variable block and a rapid heart rate.

Do Not Miss Diagnoses

  • Ventricular Tachycardia: Although less common, ventricular tachycardia can occur in patients with WPW syndrome, particularly if there is anterograde conduction down the accessory pathway. Missing this diagnosis can be life-threatening.
  • Cardiac Arrest: Patients with WPW syndrome are at risk of cardiac arrest, particularly if they have a history of syncope or near-syncope. Prompt recognition and treatment are crucial to prevent this potentially fatal outcome.

Rare Diagnoses

  • Permanent Junctional Reentrant Tachycardia (PJRT): PJRT is a rare type of supraventricular tachycardia that can occur in patients with WPW syndrome, where the accessory pathway is used for retrograde conduction.
  • Mahaim Fiber Tachycardia: Mahaim fiber tachycardia is a rare type of arrhythmia that can occur in patients with WPW syndrome, where there is an accessory pathway that connects the atria to the ventricles.
  • Fasciculoventricular Pathway: A fasciculoventricular pathway is a rare type of accessory pathway that can cause WPW syndrome, where there is a connection between the fascicles of the left ventricle and the ventricular muscle.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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