Preexcitation syndrome with myocardial infarction complicated by atrioventricular block in both normal and accessory pathways?

ABSTRACT

The preexcitation syndrome may either simulate myocardial infarction (MI) or mask it. The rapid anterograde conduction through accessory pathway may obscure atrioventricular (AV) block of the normal AV-nodal tract. To our knowledge, the case of various degree AV-nodal and bypass tract block after MI in a patient with preexcitation syndrome has been infrequently reported. We report a complex case of preexcitation syndrome presenting with first-degree and transient third-degree AV blocks in both normal and accessory pathways after acute MI. Subsequently, we further discuss the diagnosis of MI in preexcitation syndrome and analyze the electrocardiographic character of AV block in preexcitation syndrome.