30y guy presented with palpitations while playing cricket. Pulse was 220/min. Was given IV medication and reverted to normal rhythm in emergency dept. He had similar palpitations in the past, few times, but lasted few minutes and became normal so he did not seek help #MedTwitter
After IV medication. ECG showed pre-excitation pattern. So basically a case of WPW syndrome.
In Wolff-Parkinson-White (WPW) syndrome, an extra signaling pathway between the heart's upper and lower chambers causes a fast heartbeat (tachycardia). WPW syndrome is a heart condition present at birth (congenital heart defect). It is fairly rare.
The episodes of fast heartbeats seen in WPW syndrome usually aren't life-threatening, but serious heart problems can occur. Rarely, WPW syndrome may lead to #SuddenDeath in children and young adults.
Treatment of WPW syndrome may include special actions, medications, a shock to the heart (cardioversion) or a catheter procedure to stop the irregular heart rhythm (arrhythmia).

WPW syndrome may also be called preexcitation syndrome.
In general, signs and symptoms that may occur in people with WPW syndrome include:

A rapid, fluttering or pounding heartbeat (palpitations)

Chest pain

Difficulty breathing

Dizziness or lightheadedness

Fainting

Fatigue

Shortness of breath

Anxiety
Diagnosis
Treatment of WPW syndrome
In summary, WPW is a kind of electrical short circuiting in the heart which happens in some people due to abnormal connections since birth. Common symptoms are palpitations with rapid heart rate. Rarely can cause sudden cardiac arrest. Can be successfully treated if diagnosed.
And yes, there are multiple conditions which can affect the heart and cause sudden cardiac arrests. And these have existed since the origin of humans. Not everything is post covid or post vaccine. And not every death is a conspiracy.

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More from @DrDeepakKrishn1

Nov 23
While there is hue and cry about young people getting heart attacks/cardiac arrests and dying, we have so many young people who visit emergency/OPD with chest pain and ECG changes and need admission and treatment, but are in denial and refuse admission and go home. #MedTwitter
ncbi.nlm.nih.gov/pmc/articles/P… a good write up about denial of cardiac illness
@askdheeraj how do we deal with this?
Read 4 tweets
Aug 31
Hindu deities are seldom depicted without their particular ‘vahana’ (vehicles) on which they travel. These vahanas are either animals or birds and symbolises the various forces they ride. #Ganesha
While Lord Ganesha’s vahana is a mouse which symbolises crushing useless thoughts. Have you ever wondered why the elephant god rides on a tiny mouse? Well, there’s a story behind it. Read on to know.
According to Ganesha Purana, there was a celestial musician-god named Krauncha. He accidentally stepped on the foot of Muni Vamadeva who cursed him to become a mouse. However, after he recovered his temper he promised Krauncha that one day the gods themselves would bow before him
Read 7 tweets
Aug 29
When it comes to elderly patients, we just need to listen to all their problems patiently, health related and also their circumstances/other reasons for stress/anxiety. We may not be able to solve any of those .. but listening amd empathising makes them feel better. #Geriatrics Image
I have an elderly couple. The wife suffers from Dementia and he himself has undergone surgery and radiation for prostate cancer. He takes care of her with help from a caretaker. I tell them to do video consult. But he says he feels good to come and talk to me for few minutes.
Read 6 tweets
Aug 26
A close friend kept saying you should check my heart someday and midnight she landed up at ER with a heart attack. Could quickly perform an emergency angioplasty and re establish blood flow. We had a hearty laugh after it though it was a deeply emotional moment. #PropheticWords
She had messaged around evening saying she has neck pain. I advised some medication and told to see me tomorrow. Later after 2 hours she said she is not able to walk and is getting uneasiness in throat and jaw and said she'll come to hospital. ECG and echo confirmed heart attack
Women are more likely to have atypical symptoms compared to men. Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as: Neck, jaw, shoulder, upper back or upper belly (abdomen) discomfort. Shortness of breath. Pain in one or both arms.
Read 6 tweets
Aug 26
48y guy presented with breathing difficulty. BP 240/140. Acute pulmonary edema (fluid in lungs). Echo - Severe left ventricular dysfunction, EF 20%. S.creat 3.5. Stopped BP medicine 4y ago after listening to a BMHegde YouTube video saying BP medicine is not necessary #MedTwitter
It's high time the health ministry and NMC take strict action on people propagating wrong health advice on social media. Videos need to be pulled down from websites. Some of these people like BMHegde and few others have spoilt health of more people than someone can imagine.
I've personally seen hundreds of patients like this who have landed in severe complications after listening to BMH videos. Being a medical doctor who occupied such high positions of reputed institutions, he's a disgrace to our profession. Shameful.
Read 5 tweets
Aug 24
Good to see some gyms doing a clinical assessment and asking for #cardiacfitness before enrolling people. 28y guy with a family history of premature Coronary artery disease. Detected to have high BP. Overweight by 12-15kg. A basic clinical check can reveal so much information! Image
In such a patient assessing overall cardiac risk and controlling blood pressure before allowing him to exercise is crucial. In the absence of a pre-enrollment check if any cardiac event like heart attack happens, people will be quick to blame #exercise as the culprit!
Most people who develop a heart attack or cardiac arrest while exercising have a pre existing cardiac condition which has not been diagnosed. So it is critical to screen people before letting them join the gym. Also depends on how intense the training will be. Image
Read 5 tweets

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