The athlete's electrocardiogram

Wu, Jeffrey; Störk, T.; Perron, Andrew D.; Brady, William J.

doi:10.1016/j.ajem.2005.04.009

Cited by 23 publications

(10 citation statements)

References 31 publications

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“…The increased stroke volume resulting from these structural changes is thought to stimulate vagal baroreceptors and play a role in the resting bradycardia of athletes. Conduction delays, including incomplete right bundle branch blocks and atrioventricular blocks, also can be seen as a result of increased cardiac mass (16,28,29). Autonomic changes may also contribute to the common findings of benign early repolarization and T-wave inversions, although the exact mechanism for this is unclear (28).…”

Section: Interpreting the Electrocardiogrammentioning

confidence: 99%

“…If there is a doubt as to the presence of ST elevations in a patient with anginal symptoms, immediate consultation is recommended. Features to help differentiate benign LVH pattern from HCM on ECG have been described, but cannot be used to reliably make the diagnosis (29). Any LVH pattern on ECG in the appropriate clinical context should prompt further definitive diagnostic testing, specifically echocardiogram.…”

Section: Interpreting the Electrocardiogrammentioning

confidence: 99%

“…A history of premonitory symptoms such as chest pain or syncope is often observed before the fatal event (37,38). The ECG abnormalities mimic those of classic myocardial ischemia, but are transient because the ischemia is transient (29). Transthoracic echocardiography, angiography, or coronary magnetic resonance imaging may be necessary to establish the diagnosis (39,40).…”

Section: Coronary Artery Anomaliesmentioning

confidence: 99%

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The Evaluation of Cardiac Complaints in Marathon Runners

Sánchez

Pereira

Berkoff

2009

The Journal of Emergency Medicine

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Section: Interpreting the Electrocardiogrammentioning

confidence: 99%

Section: Interpreting the Electrocardiogrammentioning

confidence: 99%

Section: Coronary Artery Anomaliesmentioning

confidence: 99%

See 1 more Smart Citation

The Evaluation of Cardiac Complaints in Marathon Runners

Sánchez

Pereira

Berkoff

2009

The Journal of Emergency Medicine

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“…In rare cases, abnormalities of an athlete’s ECG may be an expression of an underlying heart disease putting the athlete at risk of sudden cardiac death (SCD) during sport 4 5 6. It is imperative that ECG abnormalities resulting from intensive physical training and those potentially associated with an increased cardiovascular risk are properly defined 7 8 9…”

mentioning

confidence: 99%

12-lead ECG in the athlete: physiological versus pathological abnormalities

Biffi²,

et al. 2009

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Participation in sports activity and regular physical training is associated with physiological structural and electrical changes in the heart (athlete's heart) that enable sustained increases in cardiac output for prolonged periods. Cardiovascular remodelling in the conditioned athlete is often associated with ECG changes. In rare cases, abnormalities of an athlete's ECG may reflect an underlying heart disease which puts the athlete at risk of arrhythmic cardiac arrest during sport. It is mandatory that ECG abnormalities resulting from intensive physical training and those of a potential cardiac pathology are properly defined. This article provides a modern approach to interpreting 12-lead ECGs of athletes based on recently published new findings. The main objective is to distinguish between physiological adaptive ECG changes and pathological ECG abnormalities. The most important aims are to prevent physiological changes in the athlete being erroneously attributed to heart disease, or signs of life-threatening cardiovascular conditions being dismissed as a normal variant of athlete's heart. As pathological ECG abnormalities not only cause alarm but also require action with additional testing to exclude (or confirm) the suspicion of a lethal cardiovascular disorder, appropriate interpretation of an athlete's ECG will prevent unnecessary distress and also result in considerable cost saving in the context of a population-based preparticipation screening programme.

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“…Similar to other repolarization abnormalities, PJTWP is seen more often in patients of Afro-Caribbean heritage (6,(10)(11)(12). A number of ECG variants have been described in highly trained athletes, and although some research suggests that anterior T-wave inversions are likely training related, other studies have not confirmed this (13)(14)(15)(16). Authorities recommend further evaluation of adult athletes, particularly males, who are found to have significant anterior TWI (5,(17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 96%