Differentiating between type A and type B**
type A (left-sided pathway): dominant R wave in V1
type B (right-sided pathway): no dominant R wave in V1
Image sourced from Wikipedia
Associations of WPW
HOCM
mitral valve prolapse
Ebstein's anomaly
thyrotoxicosis
secundum ASD
Management
definitive treatment: radiofrequency ablation of the accessory pathway
medical therapy: sotalol***, amiodarone, flecainide
*in the majority of cases, or in a question without qualification, Wolff-Parkinson-White
syndrome is associated with left axis deviation
**there is a rare type C WPW, WPW in which the delta waves are upright in leads V1-V4 but
negative in leads V5-V6
***sotalol should be avoided if there is coexistent atrial fibrillation as prolonging the refractory
period at the AV node may increase the rate of transmission through the accessory pathway,
increasing the ventricular rate and potentially deteriorating into ventricular fibrillation
,Question 1 of 292
A 34-year-old woman is admitted to the Emergency Department following a collapse. An ECG shows
a polymorphic ventricular tachycardia. Which one of the following is not associated with an
increased risk of developing torsade de pointes?
Tricyclic antidepressants
Subarachnoid haemorrhage
Hypercalcaemia
Romano-Ward syndrome
Hypothermia
,Question 1 of 292
A 34-year-old woman is admitted to the Emergency Department following a collapse. An ECG shows
a polymorphic ventricular tachycardia. Which one of the following is not associated with an
increased risk of developing torsade de pointes?
Tricyclic antidepressants
Subarachnoid haemorrhage
Hypercalcaemia
Romano-Ward syndrome
Hypothermia
Hypocalcaemia, not hypercalcaemia, causes prolongation of the QT interval and hence may predispose
to the development of torsade de pointes.
Discuss and give feedback
Long QT syndrome
External links
Life in the Fast Lane
QT Interval and Long QT syndrome
Pharmacolgy Review
2010 Drug-Induced Long QT syndrome
, Question 2 of 292
A 54-year-old man is admitted to the Emergency Department with a 15 minute history of crushing
central chest pain. Which one of the following rises first following a myocardial infarction?
AST
Troponin I
CK
CK-MB
Myoglobin
type A (left-sided pathway): dominant R wave in V1
type B (right-sided pathway): no dominant R wave in V1
Image sourced from Wikipedia
Associations of WPW
HOCM
mitral valve prolapse
Ebstein's anomaly
thyrotoxicosis
secundum ASD
Management
definitive treatment: radiofrequency ablation of the accessory pathway
medical therapy: sotalol***, amiodarone, flecainide
*in the majority of cases, or in a question without qualification, Wolff-Parkinson-White
syndrome is associated with left axis deviation
**there is a rare type C WPW, WPW in which the delta waves are upright in leads V1-V4 but
negative in leads V5-V6
***sotalol should be avoided if there is coexistent atrial fibrillation as prolonging the refractory
period at the AV node may increase the rate of transmission through the accessory pathway,
increasing the ventricular rate and potentially deteriorating into ventricular fibrillation
,Question 1 of 292
A 34-year-old woman is admitted to the Emergency Department following a collapse. An ECG shows
a polymorphic ventricular tachycardia. Which one of the following is not associated with an
increased risk of developing torsade de pointes?
Tricyclic antidepressants
Subarachnoid haemorrhage
Hypercalcaemia
Romano-Ward syndrome
Hypothermia
,Question 1 of 292
A 34-year-old woman is admitted to the Emergency Department following a collapse. An ECG shows
a polymorphic ventricular tachycardia. Which one of the following is not associated with an
increased risk of developing torsade de pointes?
Tricyclic antidepressants
Subarachnoid haemorrhage
Hypercalcaemia
Romano-Ward syndrome
Hypothermia
Hypocalcaemia, not hypercalcaemia, causes prolongation of the QT interval and hence may predispose
to the development of torsade de pointes.
Discuss and give feedback
Long QT syndrome
External links
Life in the Fast Lane
QT Interval and Long QT syndrome
Pharmacolgy Review
2010 Drug-Induced Long QT syndrome
, Question 2 of 292
A 54-year-old man is admitted to the Emergency Department with a 15 minute history of crushing
central chest pain. Which one of the following rises first following a myocardial infarction?
AST
Troponin I
CK
CK-MB
Myoglobin
