Author/Editor		Starc, Radovan; Reschner, Hrvoje; Starc, Šarlota
Title		"Koronarni EKG" pri dobro treniranem rekreativnem športniku
Translated title		Marked "coronary-like ECG changes" in a middle-aged and well-trained recreational sportsman
Type		članek
Source		In: Bručan A, Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja 8. Zbornik 9. mednarodni simpozij o urgentni medicini; 2002 jun 19-22; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2002
Volume		str. 154-5
Language		slo
Abstract		53-years old recreational sportsman (8-10 hours/week of sport activity, mostly tennis) and at least 4-6 hours/week of other domestic physical activity was checked two years ago due to unpleasent chest sensations at rest as well as during exercise. He negliged chest pains. He was an active sportsman (handball) two to three decades ago. The following atherosclerotic risk factors were present: positive family history (brother, heavy smoker) and mild hyperhyperlipoproteinemia. ECG disclosed prolonged P-Q interval 0,22 sec, incomplete right bundle branch bloch, left anterior hemiblock and significant ST segment elevations in precordial leads V2-V4 accompanied with T wave inversion in leads V1-V5. Heart ultrasound revealed normal left ventricular volumes, left ventricular hypertrophy (interventricular septum 13 mm, posterior wall 11 mm), mild septal hypokinesia and normal left ventricular ejection fraction (60%). 24-hour ambulatory ECG registered sinus rhythm with an average heart rate (range from to ), few premature ventricular beats and no additional ST segment and T wave alterations during 24 hours. He underwent maximal exercise test (cycloergometry) up to 200 W without chest pain or chest discomfort, palpitations or dyspnea. There were no premature beats. Maximal blood pressure at the end of the exercise test (9 MET, double product 22800) was 190/90 mmHg (at rest 120/85 mmHg), while maximal heart rate at the end of the test was 120 bpm (at rest 45/min). P-Q interval shortened from 0,22 to 0,18 sec at the HR 120/min, while marked ST elevation descended during the test to the isoelectric line, and T wave became positive (normal) at 100 W. Heart rate decreased after 2 minutes from the maximal 120/bpm to 70 bpm, while ECG regained its "coronary features" at heart rate 90 bpm.
Descriptors		SPORTS RECREATION CHEST PAIN ELECTROCARDIOGRAPHY, AMBULATORY EXERCISE TEST HEART HYPERTROPHY MYOCARDIAL ISCHEMIA