Case 10: An 8-Year-Old Football Player with Asymptomatic WPW Pattern

An 8-year-old child who presents with ventricular preexcitation syndrome is referred for a noninvasive assessment of the accessory pathway’s refractory period and arrhythmic risk. Although he has never experienced paroxysmal arrhythmias, continuing of sports required a cardiological certificate due to his position as a football player for Viitorul Cluj. Four trainings per week with a duration of 1–1½ h, and one match per weekend is his training period. He is asymptomatic upon physical exertion with no palpitations, dyspnea, lipotemia, or syncope. He is not on medical treatment. A discrete systolic murmur is detected during the examination; the patient weighs 38 kg, has a height of 145 cm, and has a body mass index (BMI) of 18 kg/m2. Oxygen saturation is 95%. There are no symptoms or signs of right or left heart failure. A delta wave and a short PR interval were detected on 12 lead ECG. The boy’s systolic murmur was attributed to a grade 2 tricuspid regurgitation which is considered a physiological murmur. The ultrasound of the heart revealed no abnormalities (Figs. 16.1, 16.2, 16.3, 16.4, 16.5, 16.6, 16.7, 16.8, 16.9, and 16.10).