Зображення 01386. ECG in an athlete: heart disease

An example of ECG taken on an athlete not being an ”ECG of an athlete”. In a 21-year-old male doing endurance sports, short attacks of unconsciousness started to occur in association with sporting performances. ECG recording shows a +100-degree right axis deviation in the frontal plane, R > S suggesting right ventricular hypertrophy, secondary T wave change in leads V1 and V2 (arrow), abnormal repolarization in anterior wall leads V2–5, as well as an abnormal Q wave and depressed R wave amplitudes in leads I, aVL, V5 and V6 (double arrows). Further investigations revealed a rare cardiomyopathy, arrhythmogenic right ventricular dysplasia, with myopathy changes occurring also in the left ventricle. The cause of the attacks of unconsciousness was confirmed to be rapid monomorphic ventricular tachycardia. Treatment consisted of implantation of an ICD (implantable cardioverter-defibrillator) and beta-blocker medication.