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Management of young athletes with T-wave inversions

Dr Michael Papadakis, Sports Cardiology Quiz Section Editor

The case


  • A 17-year-old Caucasian swimmer was referred for specialist investigation after an abnormal ECG on routine pre-participation cardiovascular screening.
  • He had been participating in competitive exercise since the age of 11 years.
  • His current regime consisted of swimming for 4 hours 5-6 days per week.
  • He did not report any sinister cardiac symptoms. He denied recreational or performance enhancing drug use.
  • There was no family history of premature sudden cardiac death or cardiomyopathy.
  • Clinical examination was unremarkable.

His 12-lead ECG is presented below. 




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Note: The views and opinions expressed on this page are those of the author and may not be accepted by others. While every attempt is made to keep the information up to date, there is always going to be a lag in updating information. The reader is encouraged to read this in conjunction with appropriate ESC Guidelines. The material on this page is for educational purposes and is not for use as a definitive management strategy in the care of patients. Quiz material in the site are only examples and do not guarantee outcomes from formal examinations.


Notes to editor

Dr. Silvia Castelletti, Cardiomyopathy Fellow, The Heart Hospital, London, UK
Dr. Giovanni Quarta, PhD, Consultant Cardiologist, AO Papa Giovanni XXIII, Bergamo, Italy
Dr. Michael Papadakis, Lecturer in cardiology, St George’s University of London, UK