A case of type 2 myocardial infarction caused by paroxysmal atrioventricular reentrant tachycardia complicating pre-excitation syndrome

doi:10.3969/j.issn.1004-583X.2026.09.009

Abstract

Abstract:

Objective To discuss the clinical manifestations and diagnostic and therapeutic strategies of type 2 myocardial infarction (T2MI) caused by paroxysmal atrioventricular reentrant tachycardia complicating pre-excitation syndrome. Methods A retrospective analysis was conducted of the clinical data, diagnosis, and treatment of one patient with T2MI caused by paroxysmal atrioventricular reentrant tachycardia complicating pre-excitation syndrome, and relevant literature was reviewed. Results The patient was a 31-year-old young woman with no special past medical history. She was admitted due to “sudden palpitations, syncope, and chest discomfort/ache in the precordial area for 1 hour”. Based on cardiac electrophysiology, clinical manifestations, electrocardiogram, and myocardial enzyme testing, the diagnoses of A-type pre-excitation syndrome, paroxysmal atrioventricular reentrant tachycardia, and T2MI were established. Conclusion When pre-excitation syndrome is complicated by paroxysmal atrioventricular reentrant tachycardia and abnormalities such as chest pain, syncope, and myocardial enzyme elevations are present, T2MI should be considered. Prompt diagnosis and timely treatment are necessary.

Key words: pre-excitation syndrome, tachycardia, atrioventricular node reentry, fainting, chest pain, type 2 myocardial infarction

CLC Number:

R541.77

Zhang Pengwei, Wang Zhihui, Wen Qianling, Chen Bo, Dong Xiaoli, Yao Chenyang, Li Wenbo, Dang Xiaohong. A case of type 2 myocardial infarction caused by paroxysmal atrioventricular reentrant tachycardia complicating pre-excitation syndrome[J]. Clinical Focus, 2026, 41(9): 837-841.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2026.09.009

https://www.lchc.cn/EN/Y2026/V41/I9/837

Figures/Tables 4

Fig.1 Electrocardiogram before admission: P waves were difficult to identify; ventricular rate was 205 beats/min, with ST-segment depression across multiple leads

Fig.2 The first electrocardiogram after admission After restoration of sinus rhythm following admission, a prominent delta wave was observed at the onset of the QRS complex in most leads

Fig.3 Coronary artery CT showed no obvious abnormalities

Fig.4 Cardiac electrophysiology study a. S1S2 500, 310 ms; accessory pathway refractory period; b. S1S2 500, 290 ms; AVN refractory period; c. RV S1S1 300 ms; VA 2∶1; d. After ablation: S1S2 500, 320 ms; AVN refractory period; e. During ablation: antegrade conduction was interrupted, and retrograde conduction via the accessory pathway was interrupted.

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