{"id":27238,"date":"2018-11-16T11:29:57","date_gmt":"2018-11-16T11:29:57","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=27238"},"modified":"2023-02-05T13:03:19","modified_gmt":"2023-02-05T07:33:19","slug":"ecg-quiz-4-discussion","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-4-discussion\/","title":{"rendered":"ECG Quiz 4 &#8211; Discussion"},"content":{"rendered":"<h1><span style=\"color: #008000;\">ECG Quiz 4 &#8211; Discussion<\/span><\/h1>\n<figure id=\"attachment_27239\" aria-describedby=\"caption-attachment-27239\" style=\"width: 936px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-27239 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2018\/11\/B.jpg\" alt=\"ECG Quiz 4:\u00a0Wolff-Parkinson-White Syndrome\" width=\"936\" height=\"454\" \/><figcaption id=\"caption-attachment-27239\" class=\"wp-caption-text\"><span style=\"color: #0000ff;\"><em><strong>ECG Quiz 4:\u00a0Wolff-Parkinson-White Syndrome<\/strong><\/em><\/span><\/figcaption><\/figure>\n<p><span style=\"color: #0000ff;\"><strong>Discussion<\/strong><\/span><\/p>\n<p>At one look it may look like left ventricular hypertrophy with strain pattern as there are tall R waves in lateral leads with ST segment depression and T wave inversion. One might think of old inferior wall infarction in addition as there is a prominent &#8216;Q&#8217; wave in lead III and a smaller one in aVF. Some may even consider right ventricular hypertrophy in view of dominant R waves in V1, V2.<\/p>\n<p>But if you go by the standard sequence of ECG interpretation &#8211; P, PR interval, QRS, ST segment and T wave, it becomes obvious that PR interval is short. In many leads, the slurred initial part of QRS (delta wave) is also evident (check out lead I, II and V1). Short PR interval is difficult to discern in leads III and aVF as initial part of the QRS is almost isoelectric. Taking all these findings together, the diagnosis is now obvious:\u00a0<span style=\"color: #0000ff;\">Wolff-Parkinson-White Syndrome<\/span>.<\/p>\n<p>Wolff-Parkinson-White Syndrome is characterised by short PR interval, delta wave and secondary ST-T changes. It can predispose to tachyarrhythmias, most common being atrioventricular reentrant tachycardia (PSVT).\u00a0Wolff-Parkinson-White Syndrome is due to accessory pathways which bypass the AV node and connect the atria to the ventricles with a faster bypass tract.<\/p>\n<p><a href=\"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-4\/\"><strong>Back to ECG Quiz 4<\/strong><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>ECG Quiz 4 &#8211; Discussion Discussion At one look it may look like left ventricular hypertrophy with strain pattern as there are tall R waves in lateral leads with ST segment depression and T wave inversion. One might think of old inferior wall infarction in addition as there is a prominent &#8216;Q&#8217; wave in lead [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":27239,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6,7],"tags":[],"class_list":["post-27238","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology","category-ecg-library"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ECG Quiz 4 - Discussion - Wolff-Parkinson-White Syndrome<\/title>\n<meta name=\"description\" content=\"ECG Quiz 4 - Discussion - Wolff-Parkinson-White Syndrome - short PR interval, delta waves and secondary ST-T changes are the features.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-4-discussion\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ECG Quiz 4 - Discussion - Wolff-Parkinson-White Syndrome\" \/>\n<meta property=\"og:description\" content=\"ECG Quiz 4 - Discussion - Wolff-Parkinson-White Syndrome - short PR interval, delta waves and secondary ST-T changes are the features.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-4-discussion\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2018-11-16T11:29:57+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-02-05T07:33:19+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-4-discussion\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-4-discussion\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"ECG Quiz 4 &#8211; 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