T-wave inversions and the role of de-training in the differentiation of athlete's heart from pathology: is 6 months too long?

BMJ Case Rep. 2012 Sep 30:2012:bcr0620114403. doi: 10.1136/bcr.06.2011.4403.

Abstract

Electrocardiographic changes are common in athletes. Differentiation of a physiological from a pathological substrate is important as ECG changes may indicate underlying cardiac disease placing the athlete at increased risk of sudden cardiac death. Deep T-wave inversions are uncommon in Caucasian athletes however; appear more prevalent in black athletes. Irrespective of the ethnic origin of the athlete, deep T-wave inversions require thorough follow-up. At present, 6 months de-training is recommended to assist in the differentiation of physiologic and pathologic changes where a definitive diagnosis is elusive through standard diagnostic techniques. This case study examines findings from a black and a Caucasian athlete presenting with deep T-wave inversions following a brief (ca.3 week) period of de-training resulting in normalisation of T-wave. These cases suggest that a shorter period of time may be sufficient in differentiating physiological from pathological mechanisms for deep T-wave inversions.

Publication types

  • Case Reports

MeSH terms

  • Adaptation, Physiological / physiology
  • Adult
  • Athletes*
  • Electrocardiography*
  • Heart / physiology*
  • Heart / physiopathology
  • Heart Diseases / diagnosis*
  • Heart Diseases / physiopathology
  • Humans
  • Male
  • Syncope / physiopathology
  • Time Factors
  • Young Adult