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Negative T-waves in a young female soccer player

Sabiha Gati, Sports Cardiology Quiz Section Editor

Rehabilitation and Sports Cardiology


The case

Description

16-year-old Caucasian female national level soccer athlete presented for her yearly pre-participation screening as she is part of the soccer team of our federal state:

  • The patient was asymptomatic from a cardiovascular perspective with no family history of sudden cardiac death or other cardiovascular disease.
  • The athlete plays soccer as an outfield player competitively and is currently training for about 8-10 hours a week.
  • Her physical examination was unremarkable.
  • The patient’s electrolytes were normal.

A 12-lead ECG is shown below:

 ECG case April2019-1.jpg

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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.

References

1. Sharma S, Drezner JA, Baggish A, Papadakis M, Wilson MG, Prutkin JM, et al. International Recommendations for Electrocardiographic Interpretation in Athletes. J Am Coll Cardiol. 2017;69:1057–75.

2. Schnell F, Riding N, O’Hanlon R, Axel Lentz P, Donal E, Kervio G, et al. Recognition and significance of pathological T-wave inversions in athletes. Circulation. 2015;131:165–73.

3. Finocchiaro G, Papadakis M, Dhutia H, Zaidi A, Malhotra A, Fabi E, et al. Electrocardiographic differentiation between ‘benign T-wave inversion’ and arrhythmogenic right ventricular cardiomyopathy. Europace, 2019; 21:332-8.

4. Sheikh N, Papadakis M, Wilson M, Malhotra A, Adamuz C, Homfray T, et al. Diagnostic Yield of Genetic Testing in Young Athletes With T-Wave Inversion. Circulation. 2018;138:1184–94.

5. Mitchell JH, Haskell WL, Raven PB. Classification of sports. J Am Coll Cardiol. 1994;24:864–6.

6. Pelliccia A, Solberg EE, Papadakis M, Adami PE, Biffi A, Caselli S, et al. Recommendations for participation in competitive and leisure time sport in athletes with cardiomyopathies, myocarditis, and pericarditis: position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology (EAPC). Eur Heart J. 2019;40:19–33.

7. Pelliccia A, Di Paolo FM, Quattrini FM, Basso C, Culasso F, Popoli G, et al. Outcomes in athletes with marked ECG repolarization abnormalities. N Engl J Med. 2008;358:152–61.