Key result
Cardiac investigation in a well-trained endurance athlete with a family history of sudden cardiac death revealed significant first-degree and advanced atrioventricular block.
Case Report (n=1)
Highlights the challenge of distinguishing between normal physiological variants in conditioned athletes and underlying electrical disease, emphasizing the need for comprehensive cardiovascular evaluation.
Demands comprehensive evaluation to distinguish physiological from pathological AV block in athletes; leaves open whether endurance training unmasks familial conduction disease.
BACKGROUND: The benefits of exercise are well documented. Intensive exercise for more than 4 h per week is associated with cardiovascular remodelling, including increases in ventricular dimensions, wall thickness, and left ventricular mass. These changes are influenced by sex, ethnicity, and type and duration of exercise. In highly trained endurance athletes, exercise is often associated with electrocardiographic changes at rest. CASE SUMMARY: A well-trained endurance athlete underwent cardiac investigation after his 33-year-old brother died while jogging. A resting 12-lead electrocardiogram showed significant first degree atrioventricular block (AVB), and longer monitoring revealed advanced AVB. This led to further testing and exercise restrictions. DISCUSSION: Although most electrocardiographic changes are related to athletic performance, the distinction between normal variants, often exaggerated by the physiology of the conditioned athlete, and myocardial or electrical disease may be challenging. Athletes should undergo comprehensive cardiovascular evaluation, with management based on these results.
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Santos et al. (2018) conducted a case report in Atrioventricular block (n=1). Cardiac investigation and electrocardiogram monitoring was evaluated on Electrocardiographic changes. Cardiac investigation in a well-trained endurance athlete with a family history of sudden cardiac death revealed significant first-degree and advanced atrioventricular block.
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