Female, 65 years old, asymptomatic cardiovascular.
In the last 2 years he has presented episodes of rapid, regular episodes of sudden onset and termination that last minutes and end spontaneously.
They are not related to physical activity or associated with other symptoms.
She was admitted to the emergency room due to episodes of episodes associated with similar characteristics, but with severe, retro- or depressive pain radiating to both arms.
He was admitted pale, sweating, vasocontracted, obtundated, with pulse of 164 beats per minute, regular and blood pressure of 97/67 mmHg.
ECG showed regular tachycardia with narrow QRS complex and ST depression in the inferior and lateral wall.
While being treated, the patient developed sudden vomiting, conversion of tachycardia to sinus rhythm, with disappearance of the ventricular repolarization alterations described.
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She was hospitalized for observation.
Due to the history of angina-like pain and the alterations described in his ECG, cardiac enzymes were controlled.
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The new ECG showed ventricular preexcitation syndrome, with short PR interval, positive delta wave in all precordial leads and in the inferior wall, with ventricular repolarization alterations characterized by inverse polarity to T waves.
The patient was clinically stable and in good condition, without repeat episodes of seizures or breakthrough pain, with normalization of cardiac enzymes after 48 h.
An electrophysiological study (EFS) showed left lateral paraspecific bundle (PEH) that was successfully fulgurated.
In addition, coronary angiography showed normal coronary arteries.
