Wolff-Parkinson-White syndrome: essentials for the primary care nurse practitioner.
OBJECTIVE
To provide nurse practitioners with a basic understanding of the pathophysiology, clinical characteristics, diagnostic methods, and management of Wolff-Parkinson-White (WPW) syndrome.


METHODS
Selected research and clinical articles.


CONCLUSIONS
WPW syndrome is the most common form of ventricular preexcitation. The ventricular myocardium is activated earlier than expected by an accessory conduction pathway that allows a direct electrical connection between the atria and ventricles. Although many patients remain asymptomatic throughout their lives, approximately half of the patients with WPW syndrome experience symptoms secondary to tachyarrhythmias, such as paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter, and, rarely, ventricular fibrillation and sudden death. Symptoms include palpitations, dizziness, syncope, and dyspnea. Diagnosis is usually made by electrocardiogram findings, but further testing may be warranted to confirm the diagnosis.


CONCLUSIONS
A thorough patient history and physical examination can aid the practitioner in identifying patients who may have WPW syndrome. With appropriate referral, treatment, and patient education, patients with WPW syndrome can expect to have a normal life expectancy and good quality of life.
Valderrama
Amy L
AL
Emory University in Atlanta, Georgia, USA. avalder@emory.edu
D002304:Cardiac Pacing, Artificial; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D008487:Medical History Taking; D009722:Nurse Practitioners / Q000458:organization & administration*; D024802:Nurse's Role; D009730:Nursing Assessment; D010353:Patient Education as Topic; D010808:Physical Examination; D015995:Prevalence; D011320:Primary Health Care / Q000379:methods*; D012017:Referral and Consultation; D014927:Wolff-Parkinson-White Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*