Wolff-Parkinson-White Syndrome: Causes and Treatment

Wolff-Parkinson-White Syndrome Causes and TreatmentOverviewIn a normal warm marrowedness, the galvanic impulses that symbol the kindling to grow only flow in one highroad, which begins in the sinoatrial invitee, or SA node, located in the remedy atrium. When the SA node fires, the single is dot through the right and left atria causing the chambers to contract. The impulses then act through the atrioventricular node, AV node, which is the bridge that in allows the impulses to flow from atria to the ventricles. The AV node slows buck the electric signal before sending it to the ventricles. This slight stay on allows the ventricles to assume with blood. When electric impulses reach the tendons of the ventricles, they contract, causing them to pump blood any to the lungs or to the rest of the body. When the electrical signal reaches the ventricles, the chamber them to contract.In wolf-Parkinson-white syndrome, as well as acknowledgen as WPW, an free conductivity pathw ay to the ventricles reaches the chambers quicker the normal. This is because impulses travel through the extra pathway as well as the normal AV node system. The impulses travel in a notice pattern. This circular pattern causing the tone to beat un ordinarily walloping patterns called arrhythmia.The arrhythmias atomic number 18 conserved an electrical antidromicities called pre-excitation syndromes, and they are in many forms. In Wolff-Parkinson-White syndrome, the near(prenominal) uncouth form of arrhythmia is known as paroxysmal supraventricular tachycardia. Many people with WPW in addition experience atrial fibrillation, an improper rapid heart rhythm.Wolff-Parkinson-White syndrome is give birth at birth, only when the scratch line symptoms oftentimes prime(prenominal) appear in teens. WPW is one of the most common causes of fast heart localize in infants and children. The syndrome affects rough 1 to 3 people in 1,000 people worldwide, but many do not everyone experience symptoms. IN China 70 percent of cases of abnormal heart, rhythm is due to WPW.The extra electrical pathway in the heart doesnt necessarily cause a fast heartbeat. However, this condition makes it possible for other processes to increase the heartbeat, including Looped electrical impulses, disorganise electrical impulsesLooped electrical impulses. The problem with a fast heartbeat usually occurs in Wolff-Parkinson-White syndrome because electrical impulses travel down one pathway and up the other one, creating a loop of signals. This condition, called AV reentrant tachycardia, sends impulses to the ventricles at a very rapid position. The ventricles, as a result, pump very quickly. disorganize electrical impulses. If electrical impulses dont begin correctly in the right atrium, they whitethorn travel across the atria in a disorganized way, causing them to beat very quickly and out of step with each other. This condition is called atrial fibrillation. These disorganized signals also increase the pumping rate of the ventricles to some extent. If theres an extra electrical pathway, as with Wolff-Parkinson-White syndrome, the ventricles can beat even faster. The ventricles dont curb time to fill up with blood and dont pump enough blood to the body. This less common condition can be life-threatening.HistoryIn 1930, Wolff, Parkinson and White draw a distinct electrocardiograph (ECG) pattern in healthy preteen people with short bursts of tachycardia. In 1933, other doctors noted the reason for this irregular rhythm was a faster passage of impulses traveling through the ventricles. In 1944, doctors confirmed the presence of extra pathways.CausesThe extra electrical pathway of Wolff-Parkinson-White syndrome is present at birth. Little known to why the extra pathway delopes, but can be caused by sporadic occurrence, and is linked abnormal gene and inheritance, which accounts for a weakened a small percentage of cases. In most cases, the cause of Wolff -Parkinson-White syndrome is unknown. Most of WPW occurs randomly in the general population, occurring in about 0.1 to 3.1 per 1,000 persons. men have a higher incidence of WPW than women do, for uknown reasonsA small percentage of Wolff-Parkinson-White syndrome is caused by a mutation of the PRKAG2 gene. The mutation of the gene is also linked to hypertrophic cardiomyopathy, a form of heart disease that enlarges and weakens the cardiac muscle of the left ventricle. The PRKAG2 gene codes for a protein that is part of the AMP-activated protein kinase (AMPK) enzyme. AMPK is believed to be involved in the development of the heart before birth, as well helps mangae the energy demands inside the heart.Researchers are uncertain how PRKAG2 mutations lead to the development of WPW, but is due to the modify activity of AMP-activated protein kinase in the heart. It is unclear if the changes cause overactivate enzyme or reduce enyme activity. It is know though that the AMPK mutation allows gl ycogen to build up abnormally inside cardiac muscle, as well as being related to changes in the regulation ion channels in the heart, which play critical roles in maintaining the police van normal rhythm.Most cases of Wolff-Parkinson-White syndrome occur in people with no patent family history of the condition, and accounts for only a small percentage of all cases of this condition. The inheritory throw out of kilter typically has an autosomal dominant pattern of inheritance. Some cases of WPW are inherited. Parents who have accessory pathways may pass them on to their children. Research has indicated that incidence of preexcitation in first-degree relatives could be as high as 5.5 per 1,000 persons. About 7 to 20 percent of patients with WPW also have congenital defects within the heart.SymptomsThe extra union in the heart, called an accessory pathway, that allows electrical signals to bypass the atrioventricular node and instill from the atria to the ventricles faster than us ual. The accessory pathway also can transmit electrical impulses abnormally from the ventricles back to the atria, causing an additional contraction of the atria, leading to an abnormally fast heartbeat, called tachycardia and other arrhythmias. About 80 percent of people with symptoms first have them between the ages of 11 and 50. Complications of Wolff-Parkinson-White syndrome can occur at any age, although some individuals born with an accessory pathway in the heart never experience any health problems associated with the condition. Resulting symptoms of the arrhythmias are dizziness, a sensation of zip or pounding in the chest called palpitations, shortness of breath, fainting, and rarely associated with cardiac arrest and sudden death. Some people have WPW without any symptoms at all.The most common arrhythmia associated with Wolff-Parkinson-White syndrome is called paroxysmal supraventricular tachycardia. A person experiencin an tachycardia outcome will have heart rate great er than 230 beats per number and normal blood pressure. An episode of a tachycardia begin suddenly and in conclusion for a few seconds or several hours, and often happen during exercise.Wolff-Parkinson-White syndrome often occurs with other structural abnormalities of the heart or underlying heart disease. The most common heart defect associated with the condition is Ebstein anomaly, which affects the valve that allows blood to flow from the right atrium to the right ventricle (the tricuspid valve). Additionally, Wolff-Parkinson-White syndrome can be a region of several other genetic syndromes, including hypokalemic nightly paralysis (a condition that causes episodes of perfect muscle weakness), Pompe disease (a disorder characterized by the storage of excess glycogen), and tuberous sclerosis (a condition that results in the harvest-festival of noncancerous tumors in many move of the body).TreatmentsTreatments for WPW depends on the type , frequency, and associated symptoms o f the arrhythmias experienced. tachycardia may correct itself, but often necessitate treatment. The goal of treatments for Wolff-Parkinson-White syndrome is to slow a fast heart rate when it occurs and stay future episodes. Ways to slow your heartbeat include Vagal maneuvers. Medications, and processs. Whether a person will be treated with medication or with an cutting out procedure depends on several factors. These include the severity and frequency of symptoms, take chances for future arrhythmias and patient preference.Vagal maneuvers affect the vagus tinder, which is the same nerve that regulate heartbeats, and is usally the first treatment tried. Vagal maneuvers, which include coughing, bearing down as if you are having a bowel movement, and putting an icepack on your face, are often performed during an episode of a fast heartbeat. These actions sometimes resulting in slowed conduction of electrical impulses through the AV node.If vagal maneuvers do not hang in the fast heartbeat, often medicine is destinyed. Often an injection of an anti-arrhythmic medication, such as adenosine, or pill versions of drugs, such as flecainide (Tambocor) or propafenone (Rythmol), may be percribed to be taken in response to episode of a fast heartbeat that doesnt respond to vagal maneuvers. Anti-arrhythmic medications may prevent a fast heart rate all together when taken regularly. Medications are usually given to people who experience frequent arrhythmias who cannot, or do not want to undergo surgical operation.In people with WPW, whose heart rate can not be controlled with medications, ablation can improve symptoms and recruit the abnormal arrhythmias. The most common procedure used to interrupt the abnormal pathway is radiofrequency, also known as or catheter ablation. This procedure involves inserting a catheter in an incision in the groin area and running the catheter to the heart area. Electrodes at the catheter tips are heated to damage (ablate) the extra el ectrical pathway and prevent it from sending electrical signals. When the catheter reaches the heart, the extra electrical pathway is washed-up using radiofrequency. This procedure is highly effective with a success rate for the procedure ranges between 85 95%, and complications which can include heart injury or infection are uncommon. Successful ablation ends the need for medication.Another procedure done to elevate the symptoms of Wolff-parkinson-white syndrome is cardioversion. cardioversion is a procedure where a shock is delivered to your heart through paddles or patches on your chest. The current affects the electrical impulses in your heart and restores a normal rhythm. Its typically used when maneuvers and medications arent effective.When all other forms of treatments have not worked open-heart surgery is almost 100 percent. However, because radiofrequency catheter ablation is almost as effective and less invasive, surgery for Wolff-Parkinson-White syndrome is now rare. Ho wever, surgery is usually done only if the patient must have surgery for other reasons. fond implicationsA person with WPW have several Social implications they must deal with. Since Wolff-Parkinson-White syndrome often occurs with other structural abnormalities of the heart or underlying heart disease, a person monitor there heart health carefully. In Addition to this several other genetic syndromes, including hypokalemic periodic paralysis (a condition that causes episodes of extreme muscle weakness), Pompe disease (a disorder characterized by the storage of excess glycogen), and tuberous sclerosis (a condition that results in the growth of noncancerous tumors in many parts of the body) must be monitored.Common day substances of Caffeine, Tobacco, Alcohol, and Pseudoephedrine which can contribute tachycardia episoides. This makes the person monitor there exposure to these substances and revoke places of smoking if tobacco causes symptoms. With the relatively new ohio smoking ban helps detach this social issue with smoking.Referenceshttp//www.americanheart.org/presenter.jhtml?identifier=4785http//www.medicinenet.com/wolff-parkinson-white_syndrome/page2.htmhttp//www.nlm.nih.gov/medlineplus/ency/article/000151.htmhttp//my.clevelandclinic.org/heart/disorders/electric/wpw.aspxhttp//www.mayoclinic.com/health/wolff-parkinson-white-syndrome/ds00923