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Veteran athlete presenting with palpitations and pre-syncope

Sabiha Gati, Sports Cardiology Quiz Section Editor

Rehabilitation and Sports Cardiology


The case

60 year-old male endurance athlete presented to the emergency department with a 7-day history of palpitations associated with presyncope:

  • The palpitations occurred mainly at rest and were not related to exercise.
  • The athlete had been exercising intensively for almost 25 years and participated in at least one annual marathon, in cross-country skiing and running.
  • His exercise tolerance remained normal.
  • He did not report any symptoms of chest pain, dyspnoea or syncope.
  • There was no previous history of acute febrile illness.
  • No significant cardiovascular risk factors of note.
  • There is no family history of premature sudden cardiac death or cardiovascular disease.
  • He is currently not taking any medications.
  • His physical examination was completely normal.

A 12-lead ECG was performed and is shown below.

2019-05-case-ECG-12-limb-leads.JPG

 

2019-05-case-ECG-precordial-leads.JPG

 

 

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References

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Notes to editor

Author information:

Dr. Christine Kissel, Cardiology Consultant, University Heart Centre, Zurich, Switzerland/ MSc Sports Cardiology, Cardiology Clinical Academic Group, St George’s, University of London

Dr. Ardan Saguner, Electrophysiology Consultant, University Heart Centre, Zurich, Switzerland