Myocardial infarction in an individual with Wolff-Parkinson-White syndrome

D. Butcovan

Abstract: A case of recent myocardial infarction in a 24-year-old man with no known history of Wolff-Parkinson- White syndrome is reported. The patient developed during sport training an exercise tachycardia associated with palpitation and syncope. The electrocardiogram, performed by rescue team, was suggestive of Wolff-Parkinson-White syndrome. He was admitted to Cardiovascular Diseases Institute for this first attack of rapid heart beating which did not readily subside. He died suddenly after admission, with no response to resuscitation maneuvers and before other investigations were performed. Autopsy examination of the heart revealed no accessory atrioventricular connection, but revealed a recent myocardial infarction. The case underlines the potential danger of the Wolff-Parkinson-White syndrome in patients with no or minimal clinical manifestations. The rapid unexpected death can be attributed to atrial fibrillation with rapid ventricular response via the anomalous connection. A meticulous histological study of the atrioventricular function in hearts of young athletes with unexplained death is a necessity.
Keywords: unexpected death, preexcitation, Wolff-Parkinson-White syndrome.