People affected by Wolff-Parkinson-White syndrome (WPW syndrome for short) suffer from a usually non-life-threatening heart defect. Due to an additional conduction pathway for electrical impulses controlling cardiac function, tachycardia occurs. Tachycardia in young adults is often a sign that Wolff-Parkinson-White syndrome is present.
What is Wolff-Parkinson-White syndrome?
In Wolff-Parkinson-White syndrome, the heart rate disorder is caused by an extra conduction pathway for the electrical impulses. It is a congenital heart defect that usually first becomes apparent in affected individuals between the ages of 20 and 30. Significantly earlier onset in children or much later in advanced adulthood is also possible. Wolff-Parkinson-White syndrome is characterized by an abrupt onset of a strong increase in heartbeats. Tachycardia occurs, sometimes lasting only a few minutes, but in severe cases it can last for several hours. Wolff-Parkinson-White syndrome is usually not life-threatening.
Causes
Wolff-Parkinson-White syndrome causes the normal contraction of the heart to be disturbed. It is controlled by a system of excitation conductors. Electrical impulses are generated in these heart muscle cells that cause the heart to contract or relax. These impulses are transmitted exclusively via the AV node. In Wolff-Parkinson-White syndrome, an addition to this normal excitation conduction system exists. Impulses no longer propagate through the AV node alone, but find one or, rarely, several additional conductors. This leads to a circling of impulses between the atria and ventricles. The heartbeat accelerates without any notice. It can reach a frequency that is dangerous to health, although that does not necessarily occur in Wolff-Parkinson-White syndrome. Rather, there are feelings of tightness, lightheadedness, or even the anxiety often associated with palpitations. As quickly as the increased herschlag occurs, so abruptly it stops in Wolff-Parkinson-White syndrome.
Symptoms, complaints, and signs
Wolff-Parkinson-White syndrome does not always cause symptoms, and sometimes changes are detected only by an electrocardiogram. One of the most common symptoms is palpitations, which occur suddenly. The heart may then beat up to 240 times per minute, but the pulse is very regular. The palpitations are felt by some patients as excessive heart thumping, which in medicine is called “palpitation.” Others, on the other hand, experience “heart stumbling.” In addition, many sufferers also experience shortness of breath, chest pain and dizziness. After palpitations, many complain of fatigue and a pronounced urge to urinate. In many patients, the racing heart (tachycardia) also triggers anxiety, which is exacerbated by shortness of breath and dizziness. Sometimes the heart is unable to pump enough blood to the organs due to the increased heart rate, so some sufferers may also lose consciousness. In babies, WPW syndrome symptoms are rare. If a baby experiences tachycardia, he or she breathes rapidly and is very pale. It may also refuse to drink or eat and be easily irritable. Because the heart structure is not yet mature in children, Wolff-Parkinson-White syndrome can be more dangerous than in adults.
Diagnosis and course
If the tachycardias indicative of Wolff-Parkinson-White syndrome occur, an ECG is ordered by the attending physician. If abnormalities are seen there, the next step is to perform a long-term ECG to monitor cardiac activity over a longer period of time. In some cases of Wolff-Parkinson-White syndrome, a cardiac catheterization is also performed to determine the exact position of the additional excitation conductor, known as the Kent bundle. Usually, Wolff-Parkinson-White syndrome progresses without further impairment of the affected person. The attacks of palpitations are unpleasant but rarely life-threatening. In severe manifestations, sufferers tire more quickly than healthy people and are prone to fainting or dizziness. In individual cases, however, it can coincide with other heart diseases and trigger ventricular fibrillation and even cardiac death.Children who already show symptoms of Wolff-Parkinson-White syndrome often suffer from loss of appetite, have difficulty concentrating, and may experience developmental delays.
Complications
Wolff-Parkinson-White syndrome is a serious condition that must be treated by a doctor. Self-cure does not occur, and affected individuals may die from the heart defect in the worst case. As a rule, Wolff-Parkinson-White syndrome leads to disturbances of the heart rhythm. Patients are unable to perform strenuous activities or sports and are thus significantly restricted in their daily lives. Heart palpitations also occur frequently and can lead to sweating or a panic attack. In many cases, those affected also suffer from shortness of breath and thus from dizziness or vomiting. Furthermore, there is often anxiety or confusion. In cases of severe shortness of breath, patients may also lose consciousness. The treatment of Wolff-Parkinson-White syndrome is performed by surgical intervention. There are no particular complications during this procedure. However, those affected are dependent on taking medication even after the operation. In emergencies, treatment must be provided by an emergency physician. The patient’s life expectancy is also significantly reduced and limited by Wolff-Parkinson-White syndrome.
When should you see a doctor?
Seeing a doctor is mandatory at the first onset of Wolff-Parkinson-White syndrome. Those who experience sudden palpitations for the first time during exertion or at rest are confused. If the palpitations are not due to panic, anxiety, stress, hurry or other explainable impulses, the visit to the doctor should be arranged immediately. It is probably a special form of cardiac arrhythmia. WPW syndrome represents a dispositional atrioventricular reentry tachycardia. It requires treatment – especially if atrial fibrillation exists at the same time. In this case, Wolff-Parkinson-White syndrome is life-threatening because it can lead to cardiac arrest due to ventricular fibrillation. An electrocardiogram is used by the doctor to determine whether the sudden heart palpitations have an organic cause or not. In the case of Wolff-Parkinson-White syndrome, superfluous conductors to the heart are causative for the palpitations. Since the attacks of palpitations occur more frequently in Wolff-Parkinson-White syndrome, a long-term ECG is usually ordered by the attending physician. This has particular significance if it can record an attack of palpitations. The problem is that the treatment of Wolff-Parkinson-White syndrome is different from the treatment of other heart diseases. Certain heart medications, such as digitalis or verapamil, are not appropriate for Wolff-Parkinson-White syndrome. Instead, obliteration of the triggering but redundant conduction pathways to the heart via catheter ablation is usually successful. This catheter-based procedure on the left atrial side carries only minor surgical risks. It usually provides permanent relief.
Treatment and therapy
Wolff-Parkinson-White syndrome does not require treatment in every case. In many cases, it is diagnosed only by chance, as those affected are symptom-free. In other cases, patients learn so-called vagus maneuvers, which consist of movements, swallowing cold drinks or other actions that stimulate the vagus nerve and return the heartbeat to normal. In addition to these simple methods, there is the possibility of drug treatment for Wolff-Parkinson-White syndrome. Cardiac medications suitable for interrupting tachycardia are available in tablet form or even as injections. They are usually taken when symptoms present themselves and are not permanent medications for the treatment of Wolff-Parkinson-White syndrome. A defibrillator is used when a particularly severe episode of palpitations occurs. The surge of electricity administered interrupts the impulse circuit and the heartbeat returns to normal. If the exact position of the Kent bundle is known, it is also possible to eliminate the anomaly of Wolff-Parkinson-White syndrome with a high success rate. This involves using a cardiac catheter to heat the relevant muscle site in the heart with electricity to such an extent that the cells there specifically die off and the tachycardia triggered by Wolff-Parkinson-White syndrome can no longer occur in the first place.
Prevention
Preventive measures are not possible in congenital Wolff-Parkinson-White syndrome. This applies to the actual onset of the disease as well as to the phases of heart racing that occur without notice. However, heart health should be monitored regularly in Wolff-Parkinson-White syndrome.
Follow-up
The affected person has very few and limited direct follow-up measures available to him or her in most cases of Wolff-Parkinson-White syndrome. For this reason, the affected person should see a physician early in the course of this disease, thereby preventing possible other complications and complaints. There is no independent cure. Since Wolff-Parkinson-White syndrome is a genetic disease, it cannot usually be completely cured. Therefore, if a child is desired, genetic testing and counseling should always be performed first to prevent recurrence of the disease in descendants. Most people affected by Wolff-Parkinson-White syndrome are dependent on taking medication. All the doctor’s instructions should be followed. Likewise, the correct dosage and also regular intake should be observed. In many cases, the Wolff-Parkinson-White syndrome can also be very useful contact with other sufferers of the disease, as this can lead to an exchange of information, which can facilitate everyday life.
What you can do yourself
Patients with Wolff-Parkinson-White syndrome suffer from a severe heart defect. This poses a threat to life. For this reason, cooperation with the attending physician is enormously important. Any situation of physical or emotional stress should be avoided or minimized. In the area of self-help, care should be taken to avoid physical overexertion, and rest periods should be taken when the first symptoms set in. Overweight should be avoided, as this leads to further severe impairment of cardiac activity. Therefore, the daily food intake should be controlled and optimized if necessary. Similarly, sporting activities should only be undertaken after consultation with the attending physician. Most sports cannot be performed by patients with Wolff-Parkinson-White syndrome. Therefore the leisure time activities have to be adapted to the health possibilities. In order to better cope with situations of mental stress, cooperation with a psychotherapist helps. Everyday developments and events should not lead to cognitive problems. Therefore, in case of insomnia or circling thoughts, existing disagreements should be addressed openly. Existing disputes and interpersonal misunderstandings should be settled as soon as possible. Helpfully the promotion of the joy of life and the well-being of the on the further health development proved. Since the focus of one’s life should be increasingly directed to activities and situations that lead to an improvement in the quality of life.
