Myocardial infarction in a patient with WPW syndrome. Lifting the veil.

Wolf-Parkinson-White syndrome (WPW) syndrome can mimic myocardial infarction (MI) due to the prominent repolarization changes secondary to abnormal myocardial activation by accessory pathway. Rarely these repolarization changes might mask the classical electrocardiographic (ECG) picture of MI and present with atypical ECG features, delaying the diagnosis in the emergency room. We present a case, where the onset of the MI in WPW syndrome was identified based on delta-T wave concordance, and QRS fragmentation.