![]() ![]() T wave inversions preceded by ST-segment depressions are suggestive of underlying pathology ST segment depressions should always be considered abnormal upright T wave in aVR in the context of T wave inversion in V5/V6 is suggestive of pathology involving the left ventricular apex.T wave inversions in contiguous inferior leads or lateral leads warrant investigation in all athletes.Look for other features of arrhythmogenic cardiomyopathy if the preceding J-point is not elevated. These ECG changes, including T-wave inversions, can often return to normal with detraining (see below ECGs) outside the context of age <16 years and black ethnicity, T wave inversions beyond V2 should be investigated. T-wave inversions in leads V1-V4 are present in 12% of black athletes and are usually preceded by J-point elevation and convex ST segment elevation.T-wave inversions beyond V2 after age 16 warrants further assessment in Caucasian athletes. The juvenile ECG pattern (T-wave inversion in leads V1-V3) is acceptable up to age 16 years.The early repolarization pattern accompanied by concave ST segment elevation is seen in 25-40% of highly trained athletes more common among males, black athletes and those with voltage criteria for LVH usually seen in leads V5 and V6.Sinus bradycardia <40 bpm, Mobitz type 1 second degree AVB and junctional rhythm are not uncommon and don't warrant further investigation in asymptomatic athletes. Isolated Sokolow-Lyon voltage criterion for LVH is common in male athletes and does not warrant further investigation.Increased vagal tone (e.g., sinus bradycardia, first degree atrioventricular block ) and increased chamber size due to physiologic remodeling (e.g., left ventricular hypertrophy, bi-atrial enlargement) account for normal ECG patterns seen in highly trained athletes.The following are key points from his talk: ![]() Sanjay Sharma, co-senior author of the International Recommendations for ECG Interpretation in Athletes, reviewed his approach to the Athlete's ECG. We hope you enjoy the summaries.Įditorial Team Lead, Sports & Exercise Cardiology Clinical Topic Collectionĭr. Thank you to the FITs for all their hard work. Please feel free to contact Chris Driver ( or me ( with any questions. The full CAH agenda can be accessed here. Most of them were presenters at CAH, and all are active in the Sports and Exercise Cardiology Section FIT Interest Group. In the next few weeks, we will post summaries of key sessions written by cardiology Fellows-in-Training (FIT). The overflow capacity of attendees and number of live streaming participants exceeded 220 in total. Dear Sports and Exercise Cardiology Enthusiasts:Ĭare of the Athletic Heart 2019 (CAH), directed by Matthew Martinez MD, and Jonathan Kim, MD, convened June 20-22 at the American College of Cardiology's Heart House in Washington, DC. ![]()
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