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KINE 639 - Dr. Green Section 6 The Athlete’s Heart & ECG Reading in Conover: pages 253-271

KINE 639 - Dr. Green Section 6 The Athlete’s Heart & ECG Reading in Conover: pages 253-271. The Athlete’s Heart & ECG. Common abnormalities seen in an athlete Sinus bradycardia (up to 91%) – may be less than 50 beats / minute reflects predominance of vagul tone

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KINE 639 - Dr. Green Section 6 The Athlete’s Heart & ECG Reading in Conover: pages 253-271

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  1. KINE 639 - Dr. Green Section 6 The Athlete’s Heart & ECG Reading in Conover: pages 253-271

  2. The Athlete’s Heart & ECG • Common abnormalities seen in an athlete • Sinus bradycardia (up to 91%) – may be less than 50 beats / minute • reflects predominance of vagul tone • may exhibit junctional escape rhythm • Sinus arrhythmia • 1st and 2nd (type I) degree AV block (10% - 33%) • Left ventricular hypertrophy (up to 76%) • Incomplete RBBB (up to 51%) – QRS width between .10 and .12 seconds • Early repolarization – mild J-point and ST segment elevation • differential diagnosis – Brugada Syndrome • elevated J-point swoops into a negative T-wave • Premature atrial & ventricular contractions

  3. The Athlete’s Heart & ECG 38 year old male distance runner with sinus bradycardia (42 bpm) with periods of junctional rhythm (red arrows)

  4. The Athlete’s Heart & ECG 41 year old male distance runner with J-point and ST-segment elevation (arrows) depicting early repolarization

  5. The Athlete’s Heart & ECG Patholigical LVH LVH in an athlete Note “strain” pattern in lateral precordial leads

  6. The Athlete’s Heart & ECG Early repolarization pattern of Brugada Syndrome (elevated ST-segment goes into a negative T-wave in V1 and V2) Early repolarization pattern of an athlete (note voltage criteria for LVH is borderline) Brugada Syndrome predisposes one to Ventricular Tachycardia / Ventricular Fibrillation.

  7. The Athlete’s Heart & ECG • Causes of Sudden Death in athletes • Long QT syndrome – QT interval longer than .44 seconds • Predisposition to Torsades de Pointes, a type of V-tach • Hank Gathers died in 1990 while playing basketball (went off meds) • Hypertrophic Cardiomyopathy of the Left Ventricle • Symptoms: chest pain, dyspnea, syncope • Predisposition to V-Tach • Arrhythmogenic Cardiomyopathy of the Right Ventricle • Familial condition where RV myocardium is replace by fibro-fatty tissue • Predisposition to V-tach • Congenital Coronary Artery Anomalies • Pete Maravich – had no left coronary artery – died of MI at 40 years of age

  8. The Athlete’s Heart & ECG Long QT syndrome Torsades de Pointes associated with long QT syndrome (a deadly type of Ventricular Tachycardia)

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