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Investigation and management of an athlete with ECG abnormalities on routine screening

Dr Michael Papadakis, Sports Cardiology Quiz Section Editor

Risk Factors and Prevention

Prolonged QT interval in an elite young athlete

An 18-year-old Caucasian boxer was referred for specialist investigation after routine pre-participation screening revealed an abnormal ECG. At the time the athlete was in full training and participating in regular competitions. The athlete had been participating in competitive sport from a young age and weekly training included regular high-intensity training sessions. The athlete did not report any history of cardiovascular symptoms. There was no family history of premature sudden cardiac death, syncope or epilepsy. Clinical examination was unremarkable. Blood pressure was 128/72mmHg.

The 12-lead ECG is presented below.

 

 

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Note: The views and opinions expressed on this page are those of the author and may not be accepted by others. While every attempt is made to keep the information up to date, there is always going to be a lag in updating information. The reader is encouraged to read this in conjunction with appropriate ESC Guidelines. The material on this page is for educational purposes and is not for use as a definitive management strategy in the care of patients. Quiz material in the site are only examples and do not guarantee outcomes from formal examinations.

References

1. Calore C, Zorzi A, Sheikh N, Nese A, Facci M, Malhotra A, Zaidi A, Schiavon M, Pelliccia A, Sharma S, Corrado D. Eur Heart J 2015; doi:10.1093/eurheartj/ehv591
2. Basavarajaiah, S., Wilson, M., Whyte, G., Shah, A., Behr, E., Sharma, S., Prevalence and significance of an isolated long QT interval in elite athletes, European Heart Journal, 2007; 404: 2944-2949
3. Sheikh N, Papadakis M, Ghani S, Zaidi A, Gati S, Adami PE, Carre F, Schnell F, Wilson M, Avila P, McKenna WJ, Sharma S. Comparison of ECG criteria for the detection of cardiac abnormalities in elite black and white athletes. Circulation 2014;129:1637-1649
4. Papadakis M, Carre F, Kervio G, Rawlins J, Panoulas VF, Chandra N, Basavarajaiah S, Carby L, Fonseca T, Sharma S. The prevalence, distribution and clinical outcomes of electrocardiographic repolarisation patterns in male athletes of African/Afro-Caribbean origin. Eur Heart J 2011;32:2304-2313
5. Papadakis M, Basavarajaiah S, Rawlins J, Edwards C, Makan J, Firoozi S, Carby L, Sharma S. Prevalence and significance of T-wave inversions in predominantly Caucasian adolescent athletes. Eur Heart J 2009;30:1728-35
6. Brosnan M, La Gerche A, Kalman J, Lo W, Fallon K, MacIsaac A, Prior DL. Comparison of frequency of significant electrocardiographic abnormalities in endurance versus non-endurance athletes. Am J Cardiol 2014;113:1567e1573
7. Fremont OT, Chan JCM. Understanding Bartter syndrome and Gitelman syndrome. World J Paediatrics 2012;8:25-30
8. Chaoaf CT, Wuaf VC, Kuoaf CC, Linbf YH, Changcf CC, Chuehd SJ, Wuaf KD, Pimentae E, Stowasser M. Diagnosis and management of primary aldosteronism: An updated review. Ann Med 2013;45:375-383
9. Deligiannis A, Bjornstad H, Carre F, Heidbuchel H, Kouidi E, Panhuyzen-Goedkoope NM, Pigozzi F, Schanzerg W, Vanheesh L on behalf of the ESC Study Group of Sports Cardiology. ESC Study Group of Sports Cardiology Position Paper on adverse cardiovascular effects of doping in athletes. Eur J Cardiovasc Prev Rehabil 2006;13:687–694

Notes to editor

Dr Rebecca Robinson, Specialty Registrar Sports and Exercise Medicine Sheffield Teaching Hospital,
Dr Mike Loosemore, Consultant in Sports and Exercise Medicine University College Hospital
Professor Sanjay Sharma, Professor of Inherited Cardiac Disease and Sports Cardiology, St George’s University of London