W.P.W.Syndorome Report of 22 Cases

Abstract

In 5752 patients, who were received electrocardiographic examination for past 6 years in Mitui Clinic of Iwate Medical College. Morioka Railway Hospital and Kazuno Hospital, 22 cases (0.38%) had W. P. W. syndrome. Some of them had very interesting findings or courses. The authors reported on the electrocardiographic and clinical observation of these cases. Method 1. In all cases, standard limb leads, unipolar limb leads (Goldberger) and unipolar precordial leads were taken and analysed. 2. The effects of various agents (procaine amide, epinephrine, atropine, sodium succinate, standing, exercise and deep inspiration) on the W. P. W. type electrocardiogram (ECG) in terms of abolishing it were examined, and if normal type ECG were gained, pathologic findings in them were searched. 3. Paroxysmal tachycardia and other clinical findings in all cases were investigatd. Results and Discussion 1) 15 cases (68%) were men and 7 cases (32%) were women. The age range was 8 to 72 years, on the average 32 years, and the majority were between 20 and 50 years. 2) There was no correlation between W. P. W. syndrome and occupation. In any occupation, no one could not do his work by suffering from W. P. W. syndrome. But an engine-driver of train with paroxysmal tachycardia was given an another position, taking precaution against a terrible accident. 3) In symptomes, palpitation was seen most frequently, 86% of all cases, and it was thought that this symptome originated from paroxysmal tachycardia of W. P. W. syndrome. 4) Complications were seen in 9 cases : 4 cases of essential hypertension, 1 case of myocardial infarction, 1 case of pulmonary tuberculosis, 1 case of vasoneurosis and 1 case of pregnancy in its 7 th month. There was no special correlation between W. P. W. syndrome and these complications, but in a case of myocardial infarction, it was thought that paroxysmal tachycardia of W. P. W. syndrome accelerated attacks of myocardial infarction. 5) Some abnormalities were seen in physical examination of the heart and in measurement of the arterial blood pressure, but all of them were derived from the complications or were functional. 6) paroxysmal tachycardia was seen in 20 cases (90%). The age range in which paroxysmal tachycardia was induced for the first time was 8 to 66 years. The range of frequency of attacks of paroxysmal tachycardia was from once a day to once in 40 years. The range of duration of attacks of paroxymal tachycardia was from 1 2 seconds to 4 hours. The most frequent occasion of the attacks of paroxysmal tachycardia was fatigue. ECG drawing the attack of paroxysmal tachycardia was taken only in 2 cases, and they were both superior ventricular paroxysmal tachycardia,