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Arrhythmias in Athletes
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Arrhythmias in Athletes
, Dysrhythmias in Athletes
See Also
Sudden Death in Athletes
Athletic Heart Syndrome
Pre-participation History
Sports Participation Disqualifiers
Causes
Non-Cardiac Causes
Lack of sleep
Volume depletion
Caffeine
Intake
Emotional stress
Anemia
Illicit Drug
Use
Viral illness
Personality Disorder
Causes
Cardiac Dysrhthmia types
Conduction defects
Underlying
Coronary Artery Disease
(over age 40)
Manifested with rising level of ischemia
Enhanced automaticity
Sympathetic load
Increased
Afterload
stimulates stretch receptors
Irritability of pacers due to ischemia
Re-entry phenomena: Accessory bundles
Wolff-Parkinson-White Syndrome
Long-Ganong-Levine Syndrome
Re-vascularization
Post thrombolsis
Post arteriospasm
Symptoms
Red Flags
Decreased
Cardiac Output
Dizziness
Vision
changes
Lightheadedness
Syncope
Nausea
Chest
discomfort
Angina
Wall motion abnormality
Awareness of heart beat
Palpitation
s
Signs
Red Flags
Resting
Tachycardia
Hypertension
Chest
deformity (e.g.
Pectus Excavatum
)
Suspicious cardiac murmur
Diagnostics
EKG - Normal Rhythm variants in athletes
See
Athletic Heart Syndrome
Sinus Bradycardia
(>30 bpm)
First degree
AV Block
Mobitz I Second degree
AV Block
(Wenckebach)
Junctional Rhythm
Premature Beats: PACs and PVCs
Incomplete
Right Bundle Branch Block
Isolated QRS voltage criteria for LVH
Abnormal if associated left atrial enlargement,
Left Axis Deviation
, ST depression, T inversion or
Q Wave
s
Diagnostics
EKG - Abnormal findings suggesting
Cardiomyopathy
T Wave Inversion
>1 mm in >1 lead v2-6, II and avF or I and avL (except III, aVR, V1)
ST segment Depression
>0.5mm in >1 lead
Pathologic
Q Wave
s >3 mm or >40 ms in >1 lead (except III and aVR)
Complete
Left Bundle Branch Block
Wide QRS
>140 ms duration
Left Axis Deviation
Left atrial enlargement
Right Ventricular Hypertrophy
Diagnostics
EKG - Abnormal findings suggesting life threatening
Arrhythmia
risk
QT Prolongation
Brugada Syndrome
Right bundle branch with
ST Elevation
in the anterior leads
WPW Syndrome
(ventricular preexcitation)
Short PR Interval
and Delta wave at QRS suggests accessory pathway
Third degres
AV Block
Presents as
Syncope
Suggests underlying
Coronary Artery Disease
Severe
Sinus Bradycardia
(<30 bpm)
Ventricular
Arrhythmia
s
Atrial tachyarrhythmias (e.g.
Atrial Fibrillation
or
Atrial Flutter
)
References
Drezner (2013) Br J Sports Med 47:122–4 [PubMed]
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