Athletic dysrhythmias. A case report and review of the phenomenon of the 'athlete's heart'.

A 36-year-old athlete was anaesthetised for a minor surgical procedure. His heart rate fell to 30 beats/minute during the operation, the electrocardiogram showed A-V junctional rhythm. Sinus rhythm of 58 beats/minute was restored by atropine 1.2 mg. His resting 12-lead electrocardiogram showed sinus bradycardia and features consistent with a diagnosis of 'athlete's heart'. A review is presented of the physiological and electrocardiographical features of this phenomenon. The current popularity of running as a leisure pursuit makes it important that anaesthetists recognise the peculiarities of the trained athletic heart.