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Case Reports
. 2022 Nov 16;4(22):1509-1514.
doi: 10.1016/j.jaccas.2022.08.024.

The Athletic ECG: A Line of Defense Against Misinterpretation

Rahul Ghelani  1 , Ji-Jian Chow  2 , Amanda Varnava  2
Affiliations
Case Reports

The Athletic ECG: A Line of Defense Against Misinterpretation

Rahul Ghelani et al. JACC Case Rep. .

Abstract

A 17-year-old competitive athlete was found to have a minor electrocardiogram abnormality on routine screening. Cardiac magnetic resonance revealed evidence of marked myocarditis, allowing a subsequent safe abstinence from exercise. The case highlights the importance of careful electrocardiogram interpretation, especially in athletes, where physiologic adaptive changes can pose a diagnostic challenge. (Level of Difficulty: Intermediate.).

Keywords: CMR, cardiac magnetic resonance; ECG, electrocardiogram; EMB, endomyocardial biopsy; cardiac risk; echocardiography; electrocardiogram; exercise; imaging; myocarditis; sports cardiology.

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Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Initial Electrocardiogram on Presentation T-wave inversions seen in aVR, lead III (potentially normal variants but new compared to baseline electrocardiograms), and aVF.
Figure 2
Figure 2
Initial Cardiac Magnetic Resonance Images on Presentation (A to C) Cardiac magnetic resonance images suggestive of myocarditis, with subepicardial late gadolinium enhancement in the midlateral wall and midwall late gadolinium enhancement in the midinferior wall (arrows).
Figure 3
Figure 3
New Anterior T-Wave Inversion in Anterior-Lateral Leads, Lead II, and aVF on Electrocardiogram
Figure 4
Figure 4
Interval Cardiac Magnetic Resonance Revealing Significant Improvement in Previously Seen Abnormalities Arrows indicate regions with late gadolinium enhancement.
Figure 5
Figure 5
Normalization of Electrocardiogram to Baseline
See this image and copyright information in PMC

References

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