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Marked negative T waves in athletes: ECG normalization after detraining.
T Vessella1, R Cardillo, M Bianco
1Sports Medicine Unit, Catholic University of Sacred Heart, Rome, Italy - massimiliano.bianco@fastwebnet.it.
The Journal of Sports Medicine and Physical Fitness
|August 2, 2013
Summary
Ventricular repolarization abnormalities in athletes may indicate underlying heart disease, not just an athlete's heart. These ECG changes can disappear with detraining but may signal future cardiovascular complications.
Area of Science:
- Cardiology
- Sports Medicine
- Clinical Electrocardiography
Background:
- Ventricular repolarization abnormalities (VRA) in athletes with normal cardiac structure pose diagnostic challenges.
- Distinguishing athlete's heart from underlying pathology is crucial for appropriate management.
Observation:
- A case study of an athlete presenting with significant ECG abnormalities (giant negative T waves, ST depression).
- Initial echocardiogram showed a small left ventricular cavity and mild hypertrophy.
- ECG abnormalities resolved after two months of detraining, with minimal changes in echocardiogram findings.
Findings:
- Despite transient resolution of VRA with detraining, the athlete later developed cardiovascular complications suggestive of Hypertrophic Cardiomyopathy.
- VRA reappeared during high workloads and recovery in a later stress test ECG.
Implications:
- Marked VRA in athletes, even if reversible with detraining, should be considered a potential marker of underlying cardiac disease.
- This case highlights the importance of long-term follow-up for athletes with significant ECG abnormalities.
- Rethinking the interpretation of VRA in athletes to prioritize the detection of subclinical cardiac conditions.
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