PECULIARITIES OF THE ATHLETE’S ELECTROCARDIOGRAM: TRAINING-RELATED AND BORDERLINE CHANGES. PART 2

Abstract

Aim: This study aims to provide a review of scientific data on common training-related and borderline electrocardiogram (ECG) findings in athletes of various ages and training experiences. Materials and methods. This article presents the second part of a study analyzing Russian and international scientific literature on this topic. These findings are illustrated with actual ECG tracings recorded during in-depth medical examinations of athletes at the Ryazan Regional Medical Exercise Dispensary. Results. ECG remains one of the major methods for athlete health monitoring and pre-participation physical examination. ECG findings in athletes are widespread. In accordance with international ECG interpretation criteria, they are commonly divided into training-related, borderline, and pathological. Training-related ECG findings are associated with regular physical activity and reflect the athlete’s heart. This article describes early repolarization syndrome and repolarization patterns in Black and adolescent athletes. Studies show that certain ECG findings previously considered pathological result from physiological cardiac remodeling in athletes. Further evaluation of athletes with these changes typically reveals no pathology. These findings are considered borderline and include left or right axis deviation, signs of left or right atrial enlargement, and comp­lete right bundle branch block. A single borderline finding does not require further evaluation in the absence of symptoms, whereas two or more findings necessitate further medical examination to exclude cardiovascular diseases associated with sudden cardiac death. Conclusion. Knowledge of the common training-related and borderline ECG changes in athletes, along with the ability to correlate them with the athlete’s history and findings from other tests, will help minimize both overdiagnosis and underdiagnosis of heart disease in athletes.