What are the diagnosis and management of Wolff-Parkinson-White (WPW) syndrome?

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Last updated: April 22, 2025View editorial policy

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

Single Most Likely Diagnosis

  • WPW Syndrome: Characterized by the presence of an accessory electrical pathway in the heart, leading to pre-excitation of the ventricles and causing symptoms such as palpitations, tachycardia, and potentially life-threatening arrhythmias. The diagnosis is often made based on a typical ECG pattern showing a delta wave and shortened PR interval.

Other Likely Diagnoses

  • Atrial Fibrillation: A common arrhythmia that can be associated with WPW syndrome due to the accessory pathway. It presents with an irregularly irregular rhythm and can lead to rapid ventricular response.
  • Supraventricular Tachycardia (SVT): Includes various types of tachycardias originating above the ventricles, which can be related to or exacerbated by the presence of an accessory pathway in WPW syndrome.
  • Ventricular Tachycardia: Although less common, ventricular tachycardia can occur in the context of WPW syndrome, especially if there is significant pre-excitation leading to a very rapid ventricular response.

Do Not Miss Diagnoses

  • Cardiac Tamponade: Although not directly related to WPW syndrome, cardiac tamponade is a life-threatening condition that can present with tachycardia and must be considered in any patient with acute cardiac symptoms.
  • Myocardial Infarction: Acute myocardial infarction can sometimes present with arrhythmias and must be ruled out, especially in patients with risk factors for coronary artery disease.
  • Pulmonary Embolism: A condition that can cause tachycardia and must be considered due to its potential for severe consequences if missed.

Rare Diagnoses

  • Lown-Ganong-Levine Syndrome: A rare condition characterized by an accessory pathway that connects the atria to the bundle of His, leading to pre-excitation and potentially causing arrhythmias similar to WPW syndrome.
  • Mahaim Fiber Tachycardia: Involves an accessory pathway that connects the atrioventricular node to the ventricles, leading to a form of SVT. It is less common than WPW syndrome but can present with similar symptoms.
  • Fasciculoventricular Pathway: A rare type of accessory pathway that connects the fascicles of the ventricles to the ventricular muscle, potentially causing pre-excitation and arrhythmias.

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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