11/21/2023 0 Comments Abnormal q wave v1 and v25–7 In addition, there are a number of physiological adaptations to the ECG in high-level athletes, which can be misinterpreted as pathology and lead to a number of expensive and unnecessary further investigations in the athlete with a risk of increased stress, anxiety and cost to the health system. 2 Up to 66% of SCD cases in athletes have been shown to be potentially identifiable on pre-participation electrocardiogram (ECG), including inherited, electrical or structural abnormalities. 5 Studies have shown that sports activity in adolescents can trigger an increased rate of sudden death, especially in the presence of underlying structural heart disease. 3,4 Indeed, SCD is the most common non-traumatic cause of mortality in athletes. A population-based study from Australia and New Zealand showed the incidence of young SCD in the general population to be 1.3/100,000 among individuals aged 1–35, whilst a recent study of cardiac screening in young adolescent football players in the UK showed a much higher incidence of SCD of 6.8/100,000 in this athletic population. 1,2 Two recent studies have provided a realistic prevalence of young SCD in both the general population and in elite athletes. KeywordsĪthlete, screening, electrocardiogram, sudden cardiac death, channelopathy, cardiomyopathy Article:Īthletes represent the fittest individuals in our society, yet paradoxically carry an increased risk of sudden cardiac death (SCD) when compared to sedentary individuals with the same cardiac disease. This review article will highlight what is expected in normal athletic ECG adaptation and then highlight important ‘red flags’ of potential underlying pathology in elite athletes. It is imperative that any physician involved in the assessment of elite athletes is trained in the accurate interpretation of the athlete’s ECG to ensure potentially dangerous pathology is detected, but also to ensure that the athlete is not inappropriately excluded from competition or subjected to inappropriate further investigations that are both stressful for the athlete and their family, and costly for the health system. However, physiological adaptation to exercise also leads to structural and functional changes within the heart which have an impact on the ECG and may be misinterpreted as pathology. Many of the affected athletes can be diagnosed on pre-participation screening with history, physical examination and a 12-lead electrocardiogram (ECG). A number of underlying structural, arrhythmic and inherited cardiac conditions may increase the athlete’s risk of sudden cardiac death in sports. Athletes are the fittest individuals in our society however, they paradoxically carry a higher risk of sudden death compared with sedentary individuals.
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