The case
Description
- A 54-year-old master triathlete attends an inherited cardiac diseases clinic as part of familial evaluation after the sudden death of his 44-year-old brother.
- His brother died in his sleep and a subsequent post-mortem did not identify any cardiac or extra-cardiac pathology.
- The athlete has been competing for more than 30 years and has never experienced any significant cardiovascular symptoms and there was no past medical history of note.
- Clinical examination was unremarkable.
This is 12 Lead ECG undertaken as part of the evaluation:
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References
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- Unexplained sudden death, focusing on genetics and family phenotyping.
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- Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes.
Priori SG, Wilde AA, Horie M, Cho Y, Behr ER, Berul C, Blom N, Brugada J, Chiang CE, Huikuri H, Kannankeril P, Krahn A, Leenhardt A, Moss A, Schwartz PJ, Shimizu W, Tomaselli G, Tracy C. Europace (2013) 15, 1389–1406.
- Recommendations for competitive sports participation in athletes with cardiovascular disease.
Pelliccia A, Fagard R, Bjornstad HH, et al. Eur Heart J 2005;26:1422– 45.
- Eligibility recommendations for competitive athletes with cardiovascular abnormalities.
Maron BJ, Zipes DP. J Am Coll Cardiol 2005; 45:1312–75.
- Augmented ST-Segment Elevation During Recovery From Exercise Predicts Cardiac Events in Patients With Brugada Syndrome.
Makimoto H, Nakagawa E, Takaki H, Yamada Y, Okamura H, Noda T, Satomi K, Suyama K, Aihara N, Kurita T, Kamakura S, Shimizu W. J Am Coll Cardiol. 2010; 56:1576–1584.
- Unmasking the Brugada phenotype during exercise testing and its association with ventricular arrhythmia on the recovery phase. Papadakis M, Petzer E, Sharma S. Heart 2009;95:2022.
Notes to editor
Dr Harshil Dhutia, Cardiology research fellow Dr Michael Papadakis, Lecturer in Cardiology, St George’s University of London Prof Sanjay Sharma, Professor of Clinical Cardiology, St George’s University of London
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