First presentation of supraventricular tachycardia evolving into Wolff–Parkinson–White syndrome in the postpartum period: A case report

Wolff–Parkinson–White (WPW) syndrome is an electrophysiological disorder characterized by an accessory conduction pathway that predisposes individuals to supraventricular tachyarrhythmias. Although often asymptomatic, it may be unmasked during periods of physiological stress, such as the postpartum period. We present the case of a 26-year-old primigravida who underwent an emergency cesarean section at term. On postoperative day 2, she developed sudden-onset palpitations and chest discomfort. Electrocardiography revealed supraventricular tachycardia, suggestive of atrioventricular nodal reentrant tachycardia, which responded promptly to intravenous adenosine. The post-conversion electrocardiogram (ECG) revealed hallmark features of WPW syndrome, including a short PR interval, delta wave, and wide QRS complex—findings that were not apparent on earlier tracings. This post-conversion ECG was pivotal in establishing the diagnosis. The patient was managed conservatively with beta-blockers and referred for outpatient electrophysiological evaluation. This case highlights the importance of considering concealed conduction disorders in postpartum patients with new-onset arrhythmias and underscores the diagnostic utility of ECG assessment following rhythm conversion.