EKG in athletes

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Overview
Corrado et al. have published an ESC consensus document on the screening of athletes for competitive sports. Besides a good medical history and examination, a 12 lead EKG is also part of the screening. They have set up special EKG criteria for participants in competitive sports (table 1). If one of the described findings are present on the EKG, the EKG is considered 'positive' and further evaluation is mandatory which can include echocardiography, 24-h ambulatory Holter monitoring, and exercise testing. EKG Features of cardiac diseases detectable at pre-participation screening in young competitive athletes are shown in table 2.

Prevalence of EKG abnormalities in competitive athletes has been studied by Pellicia et al. (see table below). EKG abnormalities in their study increased with age and level of exercise. In young amateur athletes they found EKG abnormalities in about 7%, a number that rised to 40% in "adult elite athletes". Especially RBBB and left ventricular hypertrophy were often seen.

Recently fierce debate has been going on about whether an EKG should be part of the screening of apparently healthy young sporters. In Italy this screening is compulsory by law and this country is a strong advocate of the use of an EKG as part of this screening. However, others have stated that costs are too high for the yield (expressed in dollars per prevented sudden cardiac death) and an EKG is not included in the screening protocol of the American Heart Association.

Source

 * ECGpedia