Machado Leite Sérgio, Freitas João, Campelo Manuel, Maciel M Júlia
Serviço de Cardiologia, Centro Hospitalar São João, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
Serviço de Cardiologia, Centro Hospitalar São João, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
Rev Port Cardiol. 2016 Mar;35(3):169-77. doi: 10.1016/j.repc.2015.09.024. Epub 2016 Feb 26.
Young athletes are considered the healthiest group in society. Although rare, there are still reports of sudden death or cardiac arrest on the playing fields. Clinical evaluation is of paramount importance for the identification of possible pathological states that confer increased risk of these events. Interpretation of the electrocardiogram of young athletes can help identify changes associated with heart disease that might preclude the participation in sports. In this context, it is essential to recognize the electrocardiographic patterns that represent the structural and electrical remodeling resulting from continued adaptation to exercise, and which thus do not increase the risk of adverse events during exercise. The European Society of Cardiology (ESC) and the American Heart Association (AHA) have issued consensus documents summarizing which electrocardiographic abnormalities should be considered 'physiological', resulting from adaptation to exercise ('athlete's heart'), and which should be considered pathological and thus require further study. However, the two societies have different approaches with respect to the electrocardiographic screening of athletes. This paper provides a brief review of current evidence regarding the electrocardiographic findings considered normal and abnormal in athletes, and presents the arguments of the ESC and AHA for electrocardiographic screening in this population.
年轻运动员被认为是社会中最健康的群体。尽管此类情况罕见，但仍有在运动场上猝死或心脏骤停的报道。临床评估对于识别可能导致这些事件风险增加的病理状态至关重要。对年轻运动员心电图的解读有助于识别与心脏病相关的变化，这些变化可能会妨碍其参与体育运动。在这种情况下，必须认识到代表因持续适应运动而导致的结构和电重构的心电图模式，因此这些模式不会增加运动期间不良事件的风险。欧洲心脏病学会（ESC）和美国心脏协会（AHA）已发布共识文件，总结了哪些心电图异常应被视为因适应运动（“运动员心脏”）而产生的“生理性”异常，以及哪些应被视为病理性异常，因此需要进一步研究。然而，这两个学会在运动员心电图筛查方面采用了不同的方法。本文简要回顾了有关运动员心电图结果被视为正常和异常的当前证据，并阐述了ESC和AHA在该人群中进行心电图筛查的观点。
