ECHO 2013 / Echo and the Athlete’s heart
.pdf
Echo and the
Athlete’s heart
April 5, 2013
Carol Chen, MD
No disclosures
Thomas Herrion, 23, dies after game, HCM
Hank
Gathers, 23, dies on court, HCM
Morosini, 25 yo soccer player, SCD
Flo
Hyman,
31,dies on court, ruptured aorta (Marfan)
Causes of sudden death in athletes 19802005 (n=1435)
Maron, BJ Circulation 2007;115:1643
Common Causes of SCD in YOUNG athletes
J Am Coll Cardiol. 2013;61(10):1027-1040. doi:10.1016/j.jacc.2012.08.1032
Date of download: |
Copyright © The American College of Cardiology. |
3/28/2013 |
All rights reserved. |
AHA consensus panel: 1996/2007 update
12-point pre-participation athletic screening: Medical history
Personal history
1.Exertional chest pain/discomfort 2.Unexplained syncope/near syncope
3.Excessive exertional and unexplained dyspnea/fatigue
4.Prior recognition of a heart murmur
5.Elevated systemic BP Family history
6.Premature death (sudden) <age 50 due to heart disease
7.disability from heart disease in close relative <50yo
8.specific knowledge of cardiac conditions, HCM/DCM/LQTS, Marfan/arrhythmias
Physical examination
9.Heart Murmur (sitting / standing)
10.femoral pulses (r/o coarctation)
11.Marfan stigmata
12.BP in sitting position
ECG is not standard
Since 1982, Italian government mandated annual ECG +H/P in all competitive athletes age 1235.
IOC also mandates yearly EKGs and H/P in all Olympic participants.
of 12 lead |
(2010)31 |
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Recommendations for interpretation |
ECG in athletes. Corrado et al EHJ |
(2):243-259 |
Common training ECG |
Uncommonneeds follow |
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changes |
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sinus brady |
T wave inversion |
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PR prolongation |
ST depression |
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Incomplete RBBB |
pathologic Q |
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early repolarization |
LAE |
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isolated QRS voltage |
LAD/LAFB |
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criteria for LVH |
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Convex ST +T wave inv |
RAD/LPFB |
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V1-V4 in black athletes |
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Wenckebach |
RVH |
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Ectopic atrial rhythm |
pre-excitation |
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Junctional escape rhythm |
LBBB/RBBB |
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Long or short QT |
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Brugada-like repol |
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For a free online training module on ECG interpretation in athletes, please visit: http://learning.bmj.com/ECGathlete