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St George’s university of London, UK:Dr Sabiha Gati, Cardiac Imaging FellowDr Michael Papadakis, Lecturer in cardiologyProf Sanjay Sharma, Professor of clinical cardiologyon behalf of the EACPR Sports Cardiology Section.
A 35-year-old Caucasian female football player underwent pre-participation cardiovascular screening. She exercised for 10 hours per week. She did not report any sinister cardiac symptoms, apart from feeling slightly more breathless than her teammates. She was not on any regular medications and there was no family history of premature sudden cardiac death or cardiomyopathy. Clinical examination was unremarkable. Her 12-lead ECG is presented below.
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For further reading:[*1] Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Corrado D, Pelliccia A, Heidbuchel H, Sharma S, Link M, Basso C, Biffi A, Buja G, Delise P, Gussac I, Anastasakis A, Borjesson M, Bjornstad HH, Carre F, Deligiannis A, Dugmore D, Fagard R, Hoogsteen J, Mellwig KP, Panhuyzen-Goedkoop N, Solberg E, Vanhees L, Drezner J, Estes NA, 3rd, Iliceto S, Maron BJ, Peidro R, Schwartz PJ, Stein R, Thiene G, Zeppilli P, McKenna WJ. Eur Heart J. 2010;31:243-259[*2] Should axis deviation or atrial enlargement be categorised as abnormal in young athletes? The athlete's electrocardiogram: Time for re-appraisal of markers of pathology. Gati S, Sheikh N, Ghani S, Zaidi A, Wilson M, Raju H, Cox A, Reed M, Papadakis M, Sharma S. Eur Heart J. 2013[*3] Comparison of electrocardiographic criteria for the detection of cardiac abnormalities in elite black and white athletes. Sheikh N, Papadakis M, Ghani S, Zaidi A, Gati S, Adami PE, Carre F, Schnell F, Wilson M, Avila P, McKenna W, Sharma S. Circulation. 2014;129:1637-1649[4*] The prevalence, distribution, and clinical outcomes of electrocardiographic repolarization patterns in male athletes of african/afro-caribbean origin. Papadakis M, Carre F, Kervio G, Rawlins J, Panoulas VF, Chandra N, Basavarajaiah S, Carby L, Fonseca T, Sharma S. Eur Heart J. 2011[5*] Increased left ventricular trabeculation in highly trained athletes: Do we need more stringent criteria for the diagnosis of left ventricular non-compaction in athletes? Gati S, Chandra N, Bennett RL, Reed M, Kervio G, Panoulas VF, Ghani S, Sheikh N, Zaidi A, Wilson M, Papadakis M, Carre F, Sharma S. Heart. 2013;99:401-408[6*] Left ventricular non-compaction revisited: A distinct phenotype with genetic heterogeneity? Oechslin E, Jenni R. Eur Heart J. 2011;32:1446-1456[7*] Isolated noncompaction of left ventricular myocardium. A study of eight cases. Chin TK, Perloff JK, Williams RG, Jue K, Mohrmann R. Circulation. 1990;82:507-513[8*] Isolated noncompaction of the myocardium in adults. Ritter M, Oechslin E, Sutsch G, Attenhofer C, Schneider J, Jenni R. Mayo Clin Proc. 1997;72:26-31[9*] Left ventricular non-compaction: Insights from cardiovascular magnetic resonance imaging. Petersen SE, Selvanayagam JB, Wiesmann F, Robson MD, Francis JM, Anderson RH, Watkins H, Neubauer S. J Am Coll Cardiol. 2005;46:101-105[*10] Measurement of trabeculated left ventricular mass using cardiac magnetic resonance imaging in the diagnosis of left ventricular non-compaction. Jacquier A, Thuny F, Jop B, Giorgi R, Cohen F, Gaubert JY, Vidal V, Bartoli JM, Habib G, Moulin G. Eur Heart J. 2010;31:1098-1104[*11] Echocardiographic and pathoanatomical characteristics of isolated left ventricular non-compaction: A step towards classification as a distinct cardiomyopathy. Jenni R, Oechslin E, Schneider J, Attenhofer Jost C, Kaufmann PA. Heart. 2001;86:666-671
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