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Publication
Alterações Eletrocardiográficas Benignas em Atletas
Advisor(s)
Abstract(s)
As alterações eletrocardiográficas em atletas são comuns e geralmente refletem a
remodelação cardíaca estrutural e elétrica que decorre da adaptação fisiológica ao
exercício físico intenso e prolongado, condicionando o desenvolvimento da síndrome do
coração do atleta.
O nível e a duração da competição, capacidade aeróbia e tipo de atividade desportiva
desempenham um papel importante na magnitude destas alterações fisiológicas.
Alguns dos padrões eletrocardiográficos encontrados em atletas são considerados
normais/fisiológicos, ao passo que outros refletem, efetivamente, doença cardíaca de
base, com potencial para provocar morte súbita de causa cardíaca. O diagnóstico
diferencial entre umas e outras torna-se desafiante e reveste-se de importância acrescida
na avaliação pré-competitiva de todos os atletas.
Os padrões eletrocardiográficos mais frequentes incluem a bradicardia sinusal, a
repolarização precoce, a hipertrofia do ventrículo esquerdo, o bloqueio incompleto do
ramo direito bem como os bloqueios aurículo-ventriculares benignos.
Nesta revisão, pretende-se reunir evidência acerca da correta interpretação
eletrocardiográfica que visa distinguir os padrões sugestivos das mudanças fisiológicas
inerentes ao coração do atleta dos que resultam de doença cardíaca subjacente, sendo
importante evitar, quer o erro de deixar passar patologia sem diagnóstico correto, quer
o de criar "neuroses cardíacas" falando de alterações patológicas quando não o são.
Electrocardiographic changes in athletes are common and generally reflect structural and electrical cardiac remodeling that results from physiological adaptation to intense and prolonged physical exercise, conditioning the development of athlete's heart syndrome. However, the level and duration of competition, aerobic capacity and type of sport activity play an important role in the magnitude of these physiological changes. Some of the electrocardiographic patterns found in athletes are considered normal/physiological, while others effectively reflect underlying heart disease, with the potential to cause sudden cardiac death. Its differential diagnosis becomes challenging and is of added importance in the pre-competitive assessment of all athletes. The most common electrocardiographic patterns include sinus bradycardia, early repolarization, left ventricular hypertrophy, incomplete right bundle branch block, and benign atrioventricular blocks. This review aims to gather evidence regarding the correct electrocardiographic interpretation that distinguish the patterns suggestive of physiological changes inherent to the athlete's heart from those that result from underlying heart disease, and it is important to avoid either the error of letting pathology pass without a correct diagnosis, such as create "cardiac neuroses" by talking about pathological changes when they are not.
Electrocardiographic changes in athletes are common and generally reflect structural and electrical cardiac remodeling that results from physiological adaptation to intense and prolonged physical exercise, conditioning the development of athlete's heart syndrome. However, the level and duration of competition, aerobic capacity and type of sport activity play an important role in the magnitude of these physiological changes. Some of the electrocardiographic patterns found in athletes are considered normal/physiological, while others effectively reflect underlying heart disease, with the potential to cause sudden cardiac death. Its differential diagnosis becomes challenging and is of added importance in the pre-competitive assessment of all athletes. The most common electrocardiographic patterns include sinus bradycardia, early repolarization, left ventricular hypertrophy, incomplete right bundle branch block, and benign atrioventricular blocks. This review aims to gather evidence regarding the correct electrocardiographic interpretation that distinguish the patterns suggestive of physiological changes inherent to the athlete's heart from those that result from underlying heart disease, and it is important to avoid either the error of letting pathology pass without a correct diagnosis, such as create "cardiac neuroses" by talking about pathological changes when they are not.
Description
Keywords
Alterações Eletrocardiográficas Coração do Atleta Remodelação Cardíaca