Which of the following ECG changes in an Asymptomatic Athlete's Hea should be considered pathological'?
Answer is B (Second Degree (Mobitz 2) hea block) Second Degree (Mobitz 2) hea block should he considered a pathological finding in an Athletes Electrocardiogram. `Various degrees of atrioventricular blocks have been described in endurance athletes. First Degree Blocks and Second Degree (Mobitz Type- 1) are a common finding. However second degree (Mobitz type -2) and third degree blocks are pretty rare and should be considered pathological' The athletic hea syndrome - Spos Cardiology: From Diagnosis to Clinical Management (Springer) 2012/ 18, 19 Benign findings Physical exam * Grades 1 and 2 systolic ejection murmurs * Split S2 * S3 or S4 ECG changes * Sinus arrhythmia * Sinus bradycardia * First-degree hea block * Second-degree hea block (Mobitz 1) * Junctional escape beats * Voltage criteria for hyperophy (High QRS Voltage) * Early repolarization * Incomplete right bundle branch block * P wave increases in amplitude and duration * Tall peaked T Waves * T-wave flattening for inversion that normalizes with exercise * Prominent U waves Pathologic findings Physical exam * Systolic murmurs at the lower sternal border augmented by Valsalva and decreased with squatting * Diastolic murmurs ECG changes * Down-sloping ST-segment depression * ST elevation with broad T waves * Significant Q waves (anterior or inferior pattern) * Delta waves (Wolff-Parkinson-white) * Second-degree hea block (Mobitz 2) * Third-degree hea block * Prolonged QTC interval * LVH with ST-T wave strain pattern These findings assume an asymptomatic athlete. If an athlete is symptomatic or a possible pat o og c n ng tsfoun fuher workup is indicated.
Increased amplitude of QRS
Second Degree (Mobitz 2) hea block
Prominent U Waves
T Wave inversion