ArticleRevista medica del Instituto Mexicano del Seguro Social2025
[Wolff-Parkinson-White syndrome due to cocaine use: a case report].
Article in Revista medica del Instituto Mexicano del Seguro Social, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Wolff-Parkinson-White syndrome (WPWS) causes an accessory pathway between the atria and ventricles, in parallel with the atrioventricular node and the bundle of His; it causes a "short circuit" that deregulates the physiological pacing and causes tachycardia. A case of WPWS is described in a patient with cocaine, alcohol, and tobacco consumption. Clinical case: A 34-year-old man with a regular history of cocaine, alcohol, and tobacco use for 14 years presented with paroxysmal palpitations, chest pain, and shortness of breath. ECG 1 revealed supraventricular tachycardia with delta waves and a short P-R interval; ECG 2 revealed reversal of the tachycardia without delta waves and inverted T waves in lead 1, aVR, and aVL, and a short P-R interval; ECG 3 revealed sinus rhythm, 90 bpm, and inverted T waves in lead 3, aVR, and v1. TTE showed a normal left ventricle; a normal LVEF, greater than 50% (Simpson's method); and no stenosis or regurgitation in the mitral, tricuspid, and mitral valves. 24-hour Holter monitoring revealed non-sustained paroxysmal supraventricular tachycardia, with a narrow QRS complex, a short P-R, interval of 122 bpm, and T wave inversion during paroxysm. Reversal of paroxysm maintained a short P-R and normal T waves. Conclusions: Upon reversal of the patient's supraventricular tachycardia paroxysms, his T waves corrected (positive T waves). The inverted T waves were due to WPWS, triggered by cocaine, alcohol, and tobacco use, and possibly related to myocardial ischemic involvement.
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