{"id":29114,"date":"2019-03-21T15:42:25","date_gmt":"2019-03-21T15:42:25","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=29114"},"modified":"2019-03-21T15:42:25","modified_gmt":"2019-03-21T15:42:25","slug":"wpw-syndrome-the-great-mimicker","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/","title":{"rendered":"WPW Syndrome &#8211; the great mimicker"},"content":{"rendered":"<h2><span style=\"color: #008000;\">WPW Syndrome &#8211; the great mimicker<\/span><\/h2>\n<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/tjiTe8--x6E\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-29115\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2019\/03\/WPW-Syndrome-the-great-mimicker.jpg\" alt=\"WPW Syndrome the great mimicker\" width=\"1917\" height=\"943\"><\/p>\n<p><em><span style=\"color: #0000ff;\">WPW Syndrome the great mimicker<\/span><\/em><br \/>\n<strong><a href=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2019\/03\/WPW-Syndrome-the-great-mimicker.jpg\">Click here for a larger image<\/a><\/strong><\/p>\n<p>This ECG shows sinus bradycardia with short PR interval and delta waves (<span style=\"color: #000000;\">black arrow in V5<\/span>) indicating Wolff-Parkinson-White (WPW) syndrome. WPW syndrome is a great mimicker as shown in this ECG:<\/p>\n<ol>\n<li><strong><span style=\"color: #0000ff;\">Myocardial infarction:<\/span><\/strong> Negative delta in inferior leads (<span style=\"color: #0000ff;\">blue arrows<\/span>) may be mistaken for pathological Q waves of old myocardial infarction (pseudoinfarction pattern).<\/li>\n<li><strong><span style=\"color: #0000ff;\">Right ventricular hypertrophy:<\/span><\/strong> Tall R waves in V1, V2 (<span style=\"color: #ff0000;\">red arrows<\/span>) may be mistaken for right ventricular hypertrophy.<\/li>\n<li><strong><span style=\"color: #0000ff;\">Left ventricular hypertrophy:<\/span><\/strong> Tall R waves in V5 (<span style=\"color: #ff00ff;\">violet arrow<\/span>) may be taken as evidence of left ventricular hypertrophy.<\/li>\n<li><strong><span style=\"color: #0000ff;\">Left bundle branch block:<\/span><\/strong> Slurred R waves in lead I (<span style=\"color: #008000;\">green arrow<\/span>) may be considered as left bundle branch block. In fact the build in computer algorithm of the ECG machine diagnosed this ECG as &#8216;complete left bundle branch block&#8217;.<\/li>\n<\/ol>\n<p>All these mistakes can be avoided by systematic evaluation of the ECG which will pick up the short PR interval and delta waves, which makes the actual diagnosis evident. It is the pre-excitation which causes the delta wave. Negative delta waves can be mistaken for<\/p>\n<p>WPW syndrome is due to atrioventricular accessory pathways which bypass the delay of the atrioventricular node and cause pre-excitation of the ventricle. It is the pre-excitation which causes the delta wave. Negative delta waves may be mistaken for Q waves as in this case. Positive delta waves can contribute to prominent R waves as seen in V1 and mimic right ventricular hypertrophy. Widening of the QRS in lateral leads with a positive delta wave mimics left bundle branch block.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>WPW Syndrome &#8211; the great mimicker WPW Syndrome the great mimicker Click here for a larger image This ECG shows sinus bradycardia with short PR interval and delta waves (black arrow in V5) indicating Wolff-Parkinson-White (WPW) syndrome. WPW syndrome is a great mimicker as shown in this ECG: Myocardial infarction: Negative delta in inferior leads [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":29115,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6,7],"tags":[],"class_list":["post-29114","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 v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>WPW Syndrome - the great mimicker - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"description\" content=\"WPW Syndrome - the great mimicker: It can mimick myocardial infarction, right ventricular hypertrophy, left ventricular hypertrophy and LBBB.\" \/>\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\/wpw-syndrome-the-great-mimicker\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"WPW Syndrome - the great mimicker - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"WPW Syndrome - the great mimicker: It can mimick myocardial infarction, right ventricular hypertrophy, left ventricular hypertrophy and LBBB.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2019-03-21T15:42:25+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\\\/wpw-syndrome-the-great-mimicker\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wpw-syndrome-the-great-mimicker\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"WPW Syndrome &#8211; the great mimicker\",\"datePublished\":\"2019-03-21T15:42:25+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wpw-syndrome-the-great-mimicker\\\/\"},\"wordCount\":277,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wpw-syndrome-the-great-mimicker\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"articleSection\":[\"ECG \\\/ Electrophysiology\",\"ECG Library\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wpw-syndrome-the-great-mimicker\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wpw-syndrome-the-great-mimicker\\\/\",\"name\":\"WPW Syndrome - the great mimicker - All About Cardiovascular System and Disorders\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wpw-syndrome-the-great-mimicker\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wpw-syndrome-the-great-mimicker\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2019-03-21T15:42:25+00:00\",\"description\":\"WPW Syndrome - the great mimicker: It can mimick myocardial infarction, right ventricular hypertrophy, left ventricular hypertrophy and LBBB.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wpw-syndrome-the-great-mimicker\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wpw-syndrome-the-great-mimicker\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wpw-syndrome-the-great-mimicker\\\/#primaryimage\",\"url\":\"\",\"contentUrl\":\"\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wpw-syndrome-the-great-mimicker\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"WPW Syndrome &#8211; the great mimicker\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\",\"name\":\"All About Cardiovascular System and Disorders\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\",\"name\":\"Johnson Francis\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"caption\":\"Johnson Francis\"},\"logo\":{\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\"},\"description\":\"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/author\\\/jf\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"WPW Syndrome - the great mimicker - All About Cardiovascular System and Disorders","description":"WPW Syndrome - the great mimicker: It can mimick myocardial infarction, right ventricular hypertrophy, left ventricular hypertrophy and LBBB.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/","og_locale":"en_US","og_type":"article","og_title":"WPW Syndrome - the great mimicker - All About Cardiovascular System and Disorders","og_description":"WPW Syndrome - the great mimicker: It can mimick myocardial infarction, right ventricular hypertrophy, left ventricular hypertrophy and LBBB.","og_url":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/","og_site_name":"All About Cardiovascular System and Disorders","article_published_time":"2019-03-21T15:42:25+00:00","author":"Johnson Francis","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Johnson Francis","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/#article","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/"},"author":{"name":"Johnson Francis","@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"headline":"WPW Syndrome &#8211; the great mimicker","datePublished":"2019-03-21T15:42:25+00:00","mainEntityOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/"},"wordCount":277,"publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/#primaryimage"},"thumbnailUrl":"","articleSection":["ECG \/ Electrophysiology","ECG Library"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/","url":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/","name":"WPW Syndrome - the great mimicker - All About Cardiovascular System and Disorders","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#website"},"primaryImageOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/#primaryimage"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/#primaryimage"},"thumbnailUrl":"","datePublished":"2019-03-21T15:42:25+00:00","description":"WPW Syndrome - the great mimicker: It can mimick myocardial infarction, right ventricular hypertrophy, left ventricular hypertrophy and LBBB.","breadcrumb":{"@id":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/#primaryimage","url":"","contentUrl":""},{"@type":"BreadcrumbList","@id":"https:\/\/johnsonfrancis.org\/professional\/wpw-syndrome-the-great-mimicker\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/johnsonfrancis.org\/professional\/"},{"@type":"ListItem","position":2,"name":"WPW Syndrome &#8211; the great mimicker"}]},{"@type":"WebSite","@id":"https:\/\/johnsonfrancis.org\/professional\/#website","url":"https:\/\/johnsonfrancis.org\/professional\/","name":"All About Cardiovascular System and Disorders","description":"","publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/johnsonfrancis.org\/professional\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec","name":"Johnson Francis","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","caption":"Johnson Francis"},"logo":{"@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g"},"description":"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal","url":"https:\/\/johnsonfrancis.org\/professional\/author\/jf\/"}]}},"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/29114","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/comments?post=29114"}],"version-history":[{"count":0,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/29114\/revisions"}],"wp:attachment":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/media?parent=29114"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/categories?post=29114"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/tags?post=29114"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}