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Abnormal electrocardiographic findings in athletes: recognising changes suggestive of cardiomyopathy
  1. Jonathan A Drezner1,
  2. Euan Ashley2,
  3. Aaron L Baggish3,
  4. Mats Börjesson4,
  5. Domenico Corrado5,
  6. David S Owens6,
  7. Akash Patel7,
  8. Antonio Pelliccia8,
  9. Victoria L Vetter7,
  10. Michael J Ackerman9,10,
  11. Jeff Anderson11,
  12. Chad A Asplund12,
  13. Bryan C Cannon13,
  14. John DiFiori14,
  15. Peter Fischbach15,
  16. Victor Froelicher2,
  17. Kimberly G Harmon1,
  18. Hein Heidbuchel16,
  19. Joseph Marek17,
  20. Stephen Paul18,
  21. Jordan M Prutkin6,
  22. Jack C Salerno19,
  23. Christian M Schmied20,
  24. Sanjay Sharma21,
  25. Ricardo Stein22,
  26. Mathew Wilson23
  1. 1Department of Family Medicine, University of Washington, Seattle, Washington, USA
  2. 2Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, California, USA
  3. 3Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  4. 4Department of Cardiology, Swedish School of Sports and Health Sciences, Karolinska University Hospital, Stockholm, Sweden
  5. 5Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy
  6. 6Division of Cardiology, University of Washington, Seattle, Washington, USA
  7. 7Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
  8. 8Department of Medicine, Institute of Sport Medicine and Science, Rome, Italy
  9. 9Departments of Medicine, Pediatrics, and Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
  10. 10Divisions of Cardiovascular Diseases and Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA
  11. 11Department of Athletics, University of Connecticut, Storrs, Connecticut, USA
  12. 12Department of Family Medicine, Eisenhower Army Medical Center, Fort Gordon, Georgia, USA
  13. 13Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
  14. 14Division of Sports Medicine, University of California Los Angeles, Los Angeles, California, USA
  15. 15Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
  16. 16Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
  17. 17Midwest Heart Foundation, Oakbrook Terrace, Illinois, USA
  18. 18Department of Family and Community Medicine, University of Arizona, Tucson, Arizona, USA
  19. 19Division of Cardiology, Seattle Children's Hospital, Seattle, Washington, USA
  20. 20Division of Cardiology, University Hospital Zurich, Zurich, Switzerland
  21. 21Department of Cardivascular Sciences, St. George's University of London, London, UK
  22. 22Cardiology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
  23. 23Department of Sports Medicine, ASPETAR, Qatar Orthopedic and Sports Medicine Hospital, Doha, Qatar
  1. Correspondence to Jonathan A Drezner, Department of Family Medicine, University of Washington, 1959 NE Pacific Street, Box 356390, Seattle, Washington 98195, USA; jdrezner{at}


Cardiomyopathies are a heterogeneous group of heart muscle diseases and collectively are the leading cause of sudden cardiac death (SCD) in young athletes. The 12-lead ECG is utilised as both a screening and diagnostic tool for detecting conditions associated with SCD. Fundamental to the appropriate evaluation of athletes undergoing ECG is an understanding of the ECG findings that may indicate the presence of an underlying pathological cardiac disorder. This article describes ECG findings present in cardiomyopathies afflicting young athletes and outlines appropriate steps for further evaluation of these ECG abnormalities. The ECG findings defined as abnormal in athletes were established by an international consensus panel of experts in sports cardiology and sports medicine.

  • Cardiology
  • Athletics

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  • Competing interests None.

  • Funding None.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • ▸ References to this paper are available online at

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