Pseudo ventricular hypertrophy and pseudo myocardial infarction in Wolff-Parkinson-White syndrome

In Wolff Parkinson-White syndrome, the sequence of ventricular activation i s altered and depending on the anatomic site of the accessory conduction pa thway may result in pseudo ventricular hypertrophy and pseudo myocardial in farction patterns on electrocardiogram, The right sided accessory pathway m ay direct the depolarization vector towards left amplifying R-wave amplitud e in left-sided limb-leads simulating left ventricular hypertrophy. The lef t-sided accessory pathways may give rise to prominent R-waves in right prec ordial leads simulating right ventricular hypertrophy. The right lateral ac cessory pathways may simulate anterior infarction because of prominent Q-wa ves in right precordial leads. The left lateral accessory pathways directin g depolarization vector towards right may cause Q-waves in lateral limb lea ds simulating high lateral myocardial infarction. In posteroseptal accessor y pathway, the ventricular depolarization vector is directed superiorily gi ving rise to prominent Q-waves in inferior limb leads simulating inferior m yocardial infarction. Therefore, ventricular hypertrophy and myocardial inf arction should not be diagnosed from the electrocardiograms of Wolff-Parkin son-White syndrome. Copyright (C) 2000 by W.B. Saunders Company.