The athletic ECG

The electrocardiogram (ECG) is the most frequently performed basic cardiology investigation. Correct interpretation of the ECG is vital, both to confirm acute diagnoses such as myocardial infarction, and in the elective setting to diagnose previous or underlying cardiac abnormalities. Normal electrocardiographic parameters for the multiple components of the ECG have been identified and are applied to the general population, but it is acknowledged that cardiac conditioning occurs with frequent and sustained aerobic exercise, in turn leading to physiological changes in the ECG. Service personnel may perform exercise at a level that leads to cardiac conditioning with associated ECG changes. This clinical review will briefly address the normal ECG and consider changes associated with aerobic cardiac conditioning. By identifying what constitutes physiological non-pathological changes in the athletic ECG, this clinical review aims to assist those who interpret ECGs in Service personnel.