In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

We use cookies to optimise the design of this website and make continuous improvement. By continuing your visit, you consent to the use of cookies. Learn more

Investigation and management of an athlete with ECG abnormalities on routine screening

Dr Michael Papadakis, Sports Cardiology Quiz Section Editor


Prolonged QT interval in an elite young athlete

An 18-year-old Caucasian boxer was referred for specialist investigation after routine pre-participation screening revealed an abnormal ECG. At the time the athlete was in full training and participating in regular competitions. The athlete had been participating in competitive sport from a young age and weekly training included regular high-intensity training sessions. The athlete did not report any history of cardiovascular symptoms. There was no family history of premature sudden cardiac death, syncope or epilepsy. Clinical examination was unremarkable. Blood pressure was 128/72mmHg.

The 12-lead ECG is presented below.



Take the quiz


Interested in learning more? Access the ESC e-learning platform and discover the EACPR Sports Cardiology online courses.

Not yet an EACPR member ?

Join now


1. Calore C, Zorzi A, Sheikh N, Nese A, Facci M, Malhotra A, Zaidi A, Schiavon M, Pelliccia A, Sharma S, Corrado D. Eur Heart J 2015; doi:10.1093/eurheartj/ehv591
2. Basavarajaiah, S., Wilson, M., Whyte, G., Shah, A., Behr, E., Sharma, S., Prevalence and significance of an isolated long QT interval in elite athletes, European Heart Journal, 2007; 404: 2944-2949
3. Sheikh N, Papadakis M, Ghani S, Zaidi A, Gati S, Adami PE, Carre F, Schnell F, Wilson M, Avila P, McKenna WJ, Sharma S. Comparison of ECG criteria for the detection of cardiac abnormalities in elite black and white athletes. Circulation 2014;129:1637-1649
4. Papadakis M, Carre F, Kervio G, Rawlins J, Panoulas VF, Chandra N, Basavarajaiah S, Carby L, Fonseca T, Sharma S. The prevalence, distribution and clinical outcomes of electrocardiographic repolarisation patterns in male athletes of African/Afro-Caribbean origin. Eur Heart J 2011;32:2304-2313
5. Papadakis M, Basavarajaiah S, Rawlins J, Edwards C, Makan J, Firoozi S, Carby L, Sharma S. Prevalence and significance of T-wave inversions in predominantly Caucasian adolescent athletes. Eur Heart J 2009;30:1728-35
6. Brosnan M, La Gerche A, Kalman J, Lo W, Fallon K, MacIsaac A, Prior DL. Comparison of frequency of significant electrocardiographic abnormalities in endurance versus non-endurance athletes. Am J Cardiol 2014;113:1567e1573
7. Fremont OT, Chan JCM. Understanding Bartter syndrome and Gitelman syndrome. World J Paediatrics 2012;8:25-30
8. Chaoaf CT, Wuaf VC, Kuoaf CC, Linbf YH, Changcf CC, Chuehd SJ, Wuaf KD, Pimentae E, Stowasser M. Diagnosis and management of primary aldosteronism: An updated review. Ann Med 2013;45:375-383
9. Deligiannis A, Bjornstad H, Carre F, Heidbuchel H, Kouidi E, Panhuyzen-Goedkoope NM, Pigozzi F, Schanzerg W, Vanheesh L on behalf of the ESC Study Group of Sports Cardiology. ESC Study Group of Sports Cardiology Position Paper on adverse cardiovascular effects of doping in athletes. Eur J Cardiovasc Prev Rehabil 2006;13:687–694

Notes to editor

Dr Rebecca Robinson, Specialty Registrar Sports and Exercise Medicine Sheffield Teaching Hospital,
Dr Mike Loosemore, Consultant in Sports and Exercise Medicine University College Hospital
Professor Sanjay Sharma, Professor of Inherited Cardiac Disease and Sports Cardiology, St George’s University of London