Unique wall motion abnormalities on stress echocardiogram associated with Wolff–Parkinson–White pattern electrocardiogram: A case report

Preexcitation syndromes pose a diagnostic challenge for exercise stress testing. We present stress echocardiographic findings in patient with Wolff–Parkinson–White (WPW) pattern on surface electrocardiogram (EKG). Echocardiogram at rest demonstrated paradoxical septal motion which disappeared during peak exercise and reappeared during rest. Preexcitation pattern on EKG also disappeared at peak stress. We tried to explain the underlying mechanisms of the above abnormality and the usefulness of stress testing in this group of patients.