[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-436659-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-436659-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","electrocardiographic-abnormalities-in-a-patient-with-pre-excitation-and-acute-myocardial-infarction-undergoing-percutaneous-coronary-intervention-and-ablation-case-report","Electrocardiographic abnormalities in a patient with pre-excitation and acute myocardial infarction undergoing percutaneous coronary intervention and ablation - Case report","","Pre-excitation syndrome can imitate or hide myocardial infarction, complicating identification of acute myocardial infarction on electrocardiography. A male patient with Wolf-Parkinson-White syndrome presented with severe chest pain and electrocardiographic ST-T abnormalities, while cardiac enzymes supported non-ST-elevation myocardial infarction. Percutaneous coronary intervention treated a left anterior descending stenosis with drug-eluting stents. One month later, radiofrequency catheter ablation successfully eliminated the accessory pathway and tachycardia, highlighting early myocardial injury recognition in WPW.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/electrocardiographic-abnormalities-in-a-patient-with-pre-excitation-and-acute-myocardial-infarction-undergoing-percutaneous-coronary-intervention-and-ablation-case-report/436659/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/electrocardiographic-abnormalities-in-a-patient-with-pre-excitation-and-acute-myocardial-infarction-undergoing-percutaneous-coronary-intervention-and-ablation-case-report/436659.png","ImageObject",300,407,{"name":42,"@type":43},"Taylor Morgan","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why is diagnosing acute myocardial infarction difficult in patients with Wolff-Parkinson-White syndrome?","Question",{"text":63,"@type":64},"The abnormal activation sequence in WPW can mask classic myocardial infarction findings, and Q-wave or T-wave abnormalities may mimic acute coronary syndrome changes.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What treatment was performed after suspicion of non-ST-elevation myocardial infarction?",{"text":68,"@type":64},"Percutaneous coronary intervention was performed, dilating a stenotic lesion and implanting drug-eluting stents in the left anterior descending 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pre-excitation and acute myocardial infarction undergoing percutaneous coronary intervention and ablation  \nChye-Gen China,b,c, Wei-Ta Chena,b,c, Yung-Kuo Lina,b,c, Cheng-Chih Chunga,b,c, Ming-Hsiung Hsieha,b,c,*  \naDivision of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC; bDivision of Cardiovascular Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC; cTaipei Heart Institute, Taipei Medical University, Taipei, Taiwan, ROC  \nAbstract: 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.  \nKeywords: Electrocardiography; Myocardial infarction; Pre-excitation  \n1. INTRODUCTION  \nThe electrocardiographic diagnosis of acute myocardial infarction (AMI) in patients with Wolff-Parkinson-White (WPW) syndrome is often difficult1-3 because the abnormal activation sequence revealed through electrocardiography (ECG) in WPW syndrome may mask the characteristic ECG findings of MI. The presence of Q waves is often confusing for patients with pre-excitation and possible infarction. Moreover, the apparent T-wave abnormalities of patients with pre-excitation may mimic the clinical ECG changes of acute coronary syndrome (ACS) .4,5 Herein, we report the case of a male patient with WPW syndrome who underwent percutaneous coronary intervention for non-ST-elevation MI (NSTEMI) and radiofrequency catheter ablation (RFCA) for his accessory pathway during 2 hospitalizations. The series of ECG abnormalities are presented to raise awareness of the value of diagnosing myocardial injury early in patients with WPW syndrome.  \n*Author correspondence: Dr. Ming-Hsiung Hsieh, Division of Cardiology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, 111, Section 3, Xinglong Road, Taipei 116, Taiwan, ROC. E-mail address:  \n[mhhsieh@tmu.edu.tw](mhhsieh@tmu.edu.tw) (M.-H. Hsieh).  \nConflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2022) 85: 804-807.  \nReceived December 7, 2021; accepted February 10, 2022.  \ndoi: 10. 1097/JCMA.0000000000000750.  \nCopyright © 2022, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \n2. CASE REPORT  \nA 60-year-old man presented to our emergency department with chest pain, which had developed during exercise. His past medical history was unremarkable except for a 20-year history of smoking. His initial ECG revealed normal sinus rhythm, positive delta waves in leads I, II, and aVL and precordial leads V2-V6, and negative delta waves in leads III and aVF. The ST segment was depressed in leads I and aVL (Fig. 1A). A physical examination was unremarkable, and the laboratory data revealed levels of troponin I, creatine k","cbCaidUWdXNQ8ses","https://ap.wps.com/l/cbCaidUWdXNQ8ses","pdf",749046,"English","# Introduction\n# Case report","[{\"question\":\"Why is diagnosing acute myocardial infarction difficult in patients with Wolff-Parkinson-White syndrome?\",\"answer\":\"The abnormal activation sequence in WPW can mask classic myocardial infarction findings, and Q-wave or T-wave abnormalities may mimic acute coronary syndrome changes.\"},{\"question\":\"What treatment was performed after suspicion of non-ST-elevation myocardial infarction?\",\"answer\":\"Percutaneous coronary intervention was performed, dilating a stenotic lesion and implanting drug-eluting stents in the left anterior descending artery.\"},{\"question\":\"What was done one month later, and what was the outcome?\",\"answer\":\"Radiofrequency catheter ablation successfully treated the accessory pathway and tachycardia, with subsequent electrocardiographic resolution of repolarization abnormalities while pre-excitation persisted.\"}]","Electrocardiographic abnormalities in a patient with pre-excitation and acute myocardial infarction undergoing percutaneous coronary intervention and ablation - Case report | PDF",1790678692]