Published on:18th June 2014
    Journal of Cardiovascular Disease Research, 2014; 5(2):62-65
    Case report | doi:10.5530/jcdr.2014.2.13

    Rheumatic Mitral Stenosis Complicated with Underlying Wolff-Parkinson-White Syndrome

    Authors:

    Saraschandra Vallabhajosyula1*, Pranathi Rao Sundaragiri1, Shashaank Vallabhajosyula2, Saarwaani Vallabhajosyula2

    1Department of Internal Medicine, Alegent-Creighton University Medical Center, Creighton University School of Medicine, Omaha, NE, USA,

    2Medical Student, Kasturba Medical College, Manipal University, Manipal, KA, India

    Abstract:

    Rheumatic mitral stenosis (MS) is an acquired valvular condition and is rarely associated with Wolff-Parkinson-White (WPW) syndrome. A 51-year-old Caucasian female with known MS presented with syncopal episodes, exertional fatigue and was noted to have atrial fi brillation (AF) with wide-QRS complexes. Old electrocardiogram revealed classical fi ndings of WPW syndrome and wide-QRS was believed to be due to pre-excited AF. Transthoracic echocardiogram demonstrated moderate MS and preserved systolic function. Electrophysiological studies revealed left anterolateral accessory pathway (AP) that was successfully ablated. Pre-excited AF manifests as cardiomyopathy, hemodynamic compromise, multiorgan dysfunction, and ventricular fi brillation. Catheter ablation of AP with or without restoration of sinus rhythm is the recommended therapy, with mitral valve replacement in the same or subsequent procedure.

    Key words: Mitral stenosis, radiofrequency ablation, rheumatic heart disease, Wolff-Parkinson-White syndrome.