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Differential Diagnosis for Short PR Interval Tachycardia

Single Most Likely Diagnosis

  • Orthodromic Atrioventricular Reentrant Tachycardia (AVRT): This condition is characterized by a short PR interval due to anterograde conduction down an accessory electrical pathway in the heart, leading to a rapid heart rate. It's a common cause of supraventricular tachycardia (SVT) with a short PR interval.

Other Likely Diagnoses

  • Atrioventricular Nodal Reentrant Tachycardia (AVNRT): Although AVNRT typically presents with a longer PR interval, atypical forms can have a shorter PR interval, making it a consideration in the differential diagnosis.
  • Atrial Flutter with 1:1 Conduction: In some cases, atrial flutter can conduct 1:1 to the ventricles, especially if there's an accessory pathway or enhanced AV nodal conduction, resulting in a short PR interval and rapid ventricular rate.

Do Not Miss Diagnoses

  • Wolff-Parkinson-White (WPW) Syndrome with Atrial Fibrillation: This condition involves an accessory electrical pathway that can cause very rapid and irregular heart rhythms, potentially leading to ventricular fibrillation if not promptly recognized and treated.
  • Antidromic AVRT: A less common form of AVRT that uses an accessory pathway for both anterograde and retrograde conduction, which can also lead to very rapid heart rates and increased risk of ventricular fibrillation.

Rare Diagnoses

  • Lown-Ganong-Levine (LGL) Syndrome: A rare condition characterized by an accessory pathway that connects the atria directly to the bundle of His, leading to a short PR interval and potential for tachyarrhythmias.
  • Mahaim Fiber Tachycardia: Involves an accessory pathway that connects the atria or AV node to the ventricles, bypassing the AV node, leading to a short PR interval and potential for rapid heart rates.

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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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