Normal ecg for an athlete [150 ECG] - Bài viết - Bệnh Học
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Normal ecg for an athlete [150 ECG]

Cho điểm
Normal ECG for an athlete
This ECG was recorded from a 40-year-old man who had hypertension but was otherwise well and ran marathons. Despite showing four possible ‘abnormalities’, is the trace actually normal?



ANSWER 100

The ECG shows:
• Sinus rhythm, average rate 39/min
• Bifid P waves, best seen in the anterior chest leads
• Normal axis
• QRS complexes show left ventricular hypertrophy on voltage criteria (R wave in lead V4 = 25 mm)
• Peaked T waves
Clinical interpretation
Sinus bradycardia can be due to physical fitness, vagal overactivity or myxoedema. In a hypertensive patient, beta-blocker treatment is a possible explanation. The bifid P waves may indicate left atrial hypertrophy (‘P mitrale’), but can be normal. Voltage criteria for left ventricular hypertrophy are extremely unreliable when there is no other evidence of this. The peaked T waves could be due to hyperkalaemia but are more often a normal variant.

What to do
All these possible abnormalities are seen in normal athletes, and the likelihood is that they are of no significance. In a patient with hypertension, beta-blocker treatment could be the cause of the bradycardia.

Summary
Normal ECG for an athlete.
Nguồn: 150 ECG Problems (4th Edition)
Tác giả: John R. Hampton

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