Electrocardiographic abnormalities in a patient with pre-excitation and acute myocardial infarction undergoing percutaneous coronary intervention and ablation

Pre-excitation syndrome can either mimic or mask myocardial infarction, making the diagnosis of acute myocardial infarction difficult. Herein, we report the case of a male patient with Wolf-Parkinson-White (WPW) syndrome who presented to our emergency department with severe chest pain. Non-ST-elevation myocardial infarction was suspected because of cardiac enzyme elevation and abnormal ST-T changes identified through electrocardiography. The patient underwent percutaneous coronary intervention; a left anterior descending artery stenotic lesion was dilated, and drug-eluting stents were implanted. One month later, he underwent successful radiofrequency catheter ablation for his accessory pathway and tachycardia. We present the series of electrocardiographic ST-T abnormalities to raise awareness of the value of diagnosing myocardial injury early in patients with WPW syndrome.

Automated summary

Pre-excitation syndrome, such as Wolf-Parkinson-White (WPW) syndrome, can complicate the diagnosis of acute myocardial infarction. This case report highlights the importance of early detection of myocardial injury in patients with WPW syndrome, as it can mimic or mask the symptoms of myocardial infarction.