A case of a 59-year-old man with acute coronary syndrome and ECG features of WPW syndrome is described. The typical chest pain and release of myocardial necrosis markers were accompanied by ECG signs of preexcitation. Angiography revealed significant lesions in coronary arteries. Difficulties in ECG diagnosis of acute myocardial infaction in the presence of preexicitation are disscussed.
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