Chief Complaint: Syncope
Management
Place patient on cardiac monitor
Place defibrillator pads on the patient
If there is concern for conduction abnormalities that may cause life-threatening dysrhythmias, defibrillator pads should be placed on the patient.
Obtain an EKG
Check laboratory studies:
Basic Metabolic Panel (Calcium, Carbon dioxide, Chloride, Creatinine, Glucose, Potassium, Sodium, Urea nitrogen, or BUN
Magnesium Level
Phosphorus Level
Identify the patient potentially at risk for sudden death.
Pivotal Assessment | Findings | ||
---|---|---|---|
History | Structural Heart Disease, History of | ||
EKG | Conduction defect | QT prolongation, Brugada pattern, |
*Pre-excitation refers to early activation of the ventricles due to impulses bypassing the AV node via an accessory pathways (AP).
Also known as bypass tracts, APs are abnormal conduction pathways formed during cardiac development and can exist in a variety of anatomical locations and in some patients there may be multiple pathways.
In WPW, the AP is sometimes referred to as the Bundle of Kent, or atrioventricular bypass tract.