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Background <p>Wolf–Parkinson–White syndrome predisposes patients to tachyarrhythmias and sudden cardiac death, with pregnancy further exacerbating arrhythmia risk due to hemodynamic, hormonal, and autonomic changes. We present a rare case of a pregnant woman with Wolf–Parkinson–White syndrome, which was unmasked after successful cardioversion of unstable ventricular tachycardia.</p> Case Presentation <p>A 40-year-old Black Ethiopian pregnant woman in her 35th week of gestation presented with unstable ventricular tachycardia, requiring multiple cardioversions, along with treatment with amiodarone and magnesium sulfate. She had a similar episode of unstable ventricular tachycardia 2 years earlier that was managed with cardioversion and subsequent pharmacotherapy, including amiodarone and metoprolol. After stabilization during the current episode, the electrocardiogram showed a short PR interval, delta waves, and wide QRS complexes, indicating previously undiagnosed type A Wolf–Parkinson–White syndrome. Laboratory investigations and echocardiography were unremarkable. The patient received optimal multidisciplinary care except for the absence of an electrophysiology study, which was not available locally. Finally, she delivered a healthy neonate at term via cesarean section with favorable maternal and neonatal outcomes.</p> Conclusion <p>This case underscores a rare instance of undiagnosed Wolf–Parkinson–White syndrome presenting as a life-threatening ventricular arrhythmia in pregnancy. It highlights how vigilant post-cardioversion electrocardiogram review can unmask concealed pre-excitation, the necessity of a coordinated multidisciplinary team for prompt stabilization, and the profound impact that limited access to electrophysiology services has on patient care in resource-constrained settings.</p>

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Unmasking of Wolff–Parkinson–White syndrome following cardioversion of ventricular tachycardia in pregnancy: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月9日

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  • Gashaw Solela,
  • Adane Petros,
  • Dejuma Yadeta,
  • Chala Fekadu,
  • Yidnekachew Asrat,
  • Sintayehu Abebe

摘要

Background

Wolf–Parkinson–White syndrome predisposes patients to tachyarrhythmias and sudden cardiac death, with pregnancy further exacerbating arrhythmia risk due to hemodynamic, hormonal, and autonomic changes. We present a rare case of a pregnant woman with Wolf–Parkinson–White syndrome, which was unmasked after successful cardioversion of unstable ventricular tachycardia.

Case Presentation

A 40-year-old Black Ethiopian pregnant woman in her 35th week of gestation presented with unstable ventricular tachycardia, requiring multiple cardioversions, along with treatment with amiodarone and magnesium sulfate. She had a similar episode of unstable ventricular tachycardia 2 years earlier that was managed with cardioversion and subsequent pharmacotherapy, including amiodarone and metoprolol. After stabilization during the current episode, the electrocardiogram showed a short PR interval, delta waves, and wide QRS complexes, indicating previously undiagnosed type A Wolf–Parkinson–White syndrome. Laboratory investigations and echocardiography were unremarkable. The patient received optimal multidisciplinary care except for the absence of an electrophysiology study, which was not available locally. Finally, she delivered a healthy neonate at term via cesarean section with favorable maternal and neonatal outcomes.

Conclusion

This case underscores a rare instance of undiagnosed Wolf–Parkinson–White syndrome presenting as a life-threatening ventricular arrhythmia in pregnancy. It highlights how vigilant post-cardioversion electrocardiogram review can unmask concealed pre-excitation, the necessity of a coordinated multidisciplinary team for prompt stabilization, and the profound impact that limited access to electrophysiology services has on patient care in resource-constrained settings.