Wolff-Parkinson-White syndrome
Don Minkel
I am a non-smoking 41 year old male in good physical condition. I have
normal blood pressure and a resting pulse of about 55 BPM. I exercise on
a daily basis, usually cycling or running from 30 minutes to 120 minutes
daily. For many years now, but more so over the last 2 years I have often
had to stop completely during workouts and allow my heart rate to drop to
a reasonable level. I then can start up again comfortably but may have
another episode during the workout.
I wear a recording heart rate monitor (chest strap type) to train and I
usually shoot for a rate of about 150-160 BPM. When an episode occurs my
heart rate will suddenly rise from this range to well over 200 BPM (it
was 235 BPM yesterday) and I will suddenly feel very weak. If I stop
completely the rate will at first gradually (over a minute or so) drop to
about 200 BPM, then very abruptly (in less than a second or two) will
drop to the 110 to 120 range. I immediately feel better when the rate
makes this sudden large drop and can resume running or riding. The
episodes occur at random, having no apparent relationship to level of
exertion. I can do 40 minutes at 175 BPM with no problem sometimes, but
other times I have 2 or 3 episodes at 150 BPM. I have never had an
episode at rest or under very mild exertion. I have never lost
consciousness.
I suspect Wolff-Parkinson-White Syndrome. What other possibilities are
there? How is a diagnosis made and what do I need to say to my Primary
Care physician to prompt further investigation? If it turns out that I
have W-P-W is it safe to leave it untreated, or must I do something about
it?
Thanks in advance,
Don Minkel
Andrew Chung
Don Minkel wrote:
... <history clipped> ...
> I suspect Wolff-Parkinson-White Syndrome. What other possibilities are
> there?
(1) Paroxysmal atrial fibrillation/flutter with rapid ventricular
response (2) Paroxysmal supraventricular tachycardia. But I think
these are less likely in your case than WPW.
>How is a diagnosis made and what do I need to say to my Primary
> Care physician to prompt further investigation?
The diagnosis is made by EKG analysis. Just describe what's been
happening to you. It is possible you will need an portable EKG event
monitor to capture your paroxysmal tachyarrhythmia in action.
> If it turns out that I have W-P-W is it safe to leave it untreated,
> or must I do something about it?
There is about a 22% lifetime risk of sudden death that would occur if
the tachyarrhythmia degenerates into ventricular fibrillation which
would require shocking with a defibrillator. I recommend you take it
easy and hold off on strenuous exercise until you see your primary
physician.
I will post a small paper on WPW that I wrote a few years ago at the
following URL:
http://userwww.service.emory.edu/~achung/wpw.html
Please give me a few minutes to find it at convert to html.
Hope this helps. Feel free to email me with further questions.
--
Andrew B. Chung
http://userwww.service.emory.edu/~achung