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Sports Cardiology Casebook
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Sports Cardiology Casebook
von: Antonio Pelliccia
Springer-Verlag, 2009
ISBN: 9781848820425
243 Seiten, Download: 10149 KB
 
Format:  PDF
geeignet für: Apple iPad, Android Tablet PC's Online-Lesen PC, MAC, Laptop

Typ: B (paralleler Zugriff)

 

 
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Inhaltsverzeichnis

  Sports Cardiology Casebook 2  
  Foreword 5  
  Contents 7  
  Contributors 10  
  Introduction 14  
     References 16  
  1 A 27-Year-Old Professional Cyclist with Palpitations on Effort 18  
      Family and Personal History 18  
      Physical Examination 18  
         12-Lead ECG 18  
      Diagnostic Testing 19  
      Recommendations and Treatment 22  
      Clinical Course 22  
      Discussion 23  
  References 24  
  2 Impaired Performance in a Master Long-Distance Runner 26  
      History 26  
         Athletic History 26  
      Family History 26  
      Medication 26  
      Physical Examination 27  
      12-Lead ECG 27  
      Maximal Exercise Test with Gas Analysis 27  
      Trans-Thoracic Echocardiography 28  
      Stress Echocardiography 30  
      Diagnosis and Recommendations 30  
      Discussion 30  
  References 31  
  3 A 26-Year-Old Cyclist with Syncope on Effort 32  
      Family and Personal History 32  
      Medical History 32  
      Physical Examination 32  
      12-Lead ECG 32  
      Echocardiography 33  
      Exercise Electrocardiography 34  
      Clinical Course 34  
      Discussion 35  
      Recommendations for Sports Participation in Patients with ARVC 37  
  References 37  
  4 A 32-Year-Old Female Soccer Player with Unexplained Syncope 39  
      Previous Medical History 39  
      Physical Examination and Diagnostic Testing 39  
      Clinical Course 39  
      Family History 41  
      Type and Level of Sports Activity Performed 41  
      Physical Examination 41  
      12-Lead ECG 41  
      Diagnostic Testing 42  
         ECG Holter-Monitoring (48h) 42  
         Blood Pressure (BP)-Monitoring 43  
         Late Potentials (HV)-ECG 43  
         Exercise -- Testing 43  
         Echocardiography 44  
         Ajmalin -- Testing 44  
         Sleep Apnea Monitoring 45  
         Cardiac CT Scan 45  
         Cardiac Magnetic Resonance 45  
         Tilt Table Testing 45  
         Neurologist Consultation 46  
         Cerebral Doppler 47  
         Cerebral MRI 48  
         Ophthalmologist Examination 48  
         Laboratory Results 48  
      Final Diagnosis and Recommendations 48  
      Discussion 48  
  References 49  
  5 A 23-Year-Old Top-Level Soccer Player Suffering Syncope on Effort 50  
      Medical History 50  
      Physical Examination 50  
      12-Lead ECG 50  
      Echocardiography 50  
      Exercise Electrocardiography 50  
      Holter Monitoring 51  
      Other Diagnostic Testing 52  
      Clinical Course 52  
      Other Diagnostic Testing 53  
      Treatment 53  
      Subsequent Clinical Course 53  
      Discussion 54  
  References 55  
  6 A 21-Year-Old Female Beach Volleyball Player with Palpitations and Pre-syncope on Effort 56  
      Medical History 56  
      Physical Examination 56  
      12-Lead ECG 56  
      Diagnostic Testing 56  
      Clinical Course and Recommendations 57  
      Subsequent Follow-Up 58  
      Discussion 60  
      Summary of the Recommendations for Sports Participation in Athletes with AVNRT [ 3 , 5 ] 60  
  References 61  
  7 A 49-Year-Old Male Marathon Runner with Exercise Induced Prolonged Palpitations 62  
      Family and Personal History 62  
      Medical History 62  
      12-Lead ECG 62  
      Echocardiography 62  
      Exercise Electrocardiography 63  
      ECG Holter Monitoring 64  
      Diagnosis and Treatment 64  
      2nd Cardiovascular Evaluation 65  
         Physical Examination 65  
      12-Lead ECG 65  
      Other Testing 65  
      Treatment 65  
      Clinical Course 66  
      Discussion 67  
      Suggested Recommendations for Sports Participation in Adult and Senior Athletes with Atrial Fibrillation (AF) 68  
  References 69  
  8 A Female Cyclist with Prolonged Palpitations on Effort 71  
      Medical History 71  
      Physical Examination 71  
      Electrocardiogram 71  
      Echocardiography 71  
      ECG Holter Monitoring 71  
      Electrophysiological Study 72  
      Second Clinical Evaluation 73  
      Diagnosis and Recommendation 73  
      Discussion 75  
  References 76  
  9 The Girl with Systolic Murmur on the Left Sternal Border 77  
      Family and Personal History 77  
      Physical Examination 77  
      12-Lead ECG 77  
      Diagnostic Course 77  
      Cardiology Consultation 78  
      12-Lead ECG 78  
      Echocardiography 78  
      Diagnosis 80  
      What is the Risk for Our Patient of Continuing her Sport? 80  
      Recommendations 80  
      Discussion 80  
  References 81  
  10 Elite Tennis Player with a Complete Atrio-Ventricular Block 82  
      Medical History 82  
      Physical Examination 82  
      12-lead electrocardiogram 82  
      M-mode Echocardiogram 82  
      Electrophysiologic Study 83  
      Diagnosis and Recommendation 83  
      Clinical Course 84  
      24-Hour ECG Monitoring 84  
      Exercise Testing 84  
      Clinical Outcome 84  
      Medical History 85  
      12-Lead ECG 85  
      24-Hour Holter ECG Monitoring 85  
      Doppler-Echocardiography 85  
      Discussion 86  
  References 88  
  11 A Young Canoeist with an Abnormal Electrocardiogram 89  
      Family and Personal History 89  
      Physical Examination 89  
      12-Lead ECG 89  
      Echocardiography 89  
      Exercise Electrocardiography 90  
      ECG Holter Monitoring 90  
      Additional Diagnostic Testing 91  
      Clinical Course 92  
      Discussion 93  
  References 96  
  12 ECG Repolarization Abnormalities in an African Descent Athlete: Pathologic or Physiologic Finding? 97  
      Medical History 97  
      Physical Examination 97  
      12-Lead ECG 97  
      Echocardiography 97  
         Cardiac Magnetic Resonance (CMR) 99  
      Diagnosis and Recommendations 99  
      Discussion 100  
  References 102  
  13 A 16-Year-Old Female Runner with Prolonged QT Interval 104  
      Medical History 104  
      Physical Examination 104  
      12-Lead ECG 104  
      Other Diagnostic Testing 104  
      Diagnosis and Recommendations 106  
      Discussion 107  
      Pitfalls in the Measurements of QT Interval in Athletes 107  
      Diagnosis of LQTS in Asymptomatic Athletes 108  
      Management 109  
  References 109  
  14 Athlete with Variable QTc Interval and Abnormal T Wave Pattern 111  
      Family and Personal History 111  
      Physical Examination 111  
      12-Lead ECG 111  
      Echocardiography 111  
      Exercise Electrocardiography 112  
      ECG Holter Monitoring 113  
      Family Screening 114  
      Cardiac Magnetic Resonance 115  
      Diagnosis and Recommendations 115  
      Clinical Course 116  
      Genetic Analysis 117  
      Follow-Up 117  
      Discussion 117  
  References 119  
  15 Young Triathlete with Unusual ST-Segment Elevation in Precordial Leads 120  
      Family and Personal History 120  
      Physical Examination 120  
      12-Lead ECG 120  
      Exercise Electrocardiography 121  
      Flecainide Testing 121  
      Echocardiography 122  
      Diagnosis 123  
      Discussion 123  
      Recommendations for Sports Participation in Brugada Patients 124  
      Early Repolarization Pattern in Athletes 125  
  References 126  
  16 A 17-Year-Old Competitive Soccer Player with Pre-excitation Pattern on 12-Lead ECG 127  
      Family and Personal History 127  
      Physical Examination 127  
      12-Lead ECG 127  
      Diagnostic Course 127  
      Recommendations 128  
      Discussion 128  
  References 129  
  17 A Symptomatic Judoka with Wolff-Parkinson-White Pattern 131  
      Athletic History 131  
      Family History 131  
      Personal History 131  
      Physical Examination 131  
      12-Lead ECG 131  
      Echocardiography 132  
      Electrophysiologic Study and Ablation Procedure 132  
      Clinical Course and Recommendations 133  
      Discussion 133  
  References 135  
  18 A 35-Year-Old Competitive Cyclist with Frequent Premature Ventricular Beats 136  
      Athletes History 136  
      Previous Diagnostic Testing 136  
      Medical History 136  
      Physical Examination 137  
      12-Lead ECG 137  
      New Diagnostic Testing 137  
      Recommendations and Treatment 141  
      Clinical Course 141  
      Discussion 141  
  References 143  
  19 An Athlete with Ischemic Pattern on Exercise ECG 144  
      Family and Personal History 144  
      Physical Examination 144  
      12-Lead ECG 144  
      Exercise Electrocardiography 144  
      Echocardiography 145  
      ECG Holter Monitoring 146  
      Other Tests 146  
      Ventriculo-Coronary Angiography 147  
      Cardiac Magnetic Resonance 147  
      Diagnosis and Recommendations 148  
      Discussion 148  
  References 149  
  20 A 17-Year-Old National Cyclist with Exercise-Induced Ventricular Tachycardia 150  
      Family and Personal History 150  
      Medical History 150  
      Physical Examination 150  
      12-Lead ECG 151  
      Echocardiography 151  
      Blood Analysis 151  
      Exercise Test: Race Simulation 152  
      Holter ECG Monitoring During Bicycle Race 152  
      Recommendations 154  
      Additional Diagnostic Tests 154  
      Electrophysiologic Study 154  
      Subsequent Clinical Course 154  
      Continued Follow-Up 154  
      Final Recommendations 155  
      Discussion 155  
  References 156  
  21 A 53-Year-Old Recreational Jogger with Atrial Fibrillation 157  
      Family and Personal History 157  
      Physical Examination 157  
      12-Lead ECG 157  
      Echocardiography 158  
      Diagnosis and Treatment 158  
      Clinical Course 158  
      Discussion 159  
  References 161  
  22 Paroxysmal Atrial Fibrillation in a Professional Cyclist 162  
      Family and Personal History 162  
      Athletic History 162  
      Physical Examination 162  
      12-Lead ECG 162  
      Echocardiography 163  
      Maximal Exercise Testing with Gas Analysis 163  
      Follow-Up and Other Testing 164  
      Treatment and Recommendations 166  
      Subsequent Follow-Up 166  
      Discussion 166  
  References 167  
  23 A Female Soccer Player with Unusual Fatigability and Ventricular Arrhythmia 168  
      Medical History 168  
      Diagnostic Testing 168  
      Clinical Course 170  
      Recommendations and Treatment 170  
      Subsequent Clinical Course 170  
      Recommendations and Treatment 171  
      Discussion 171  
  References 172  
  24 A 38-Year-Old Marathon Runner with Tricuspid Valve Regurgitation 173  
      Personal Medical History 173  
      Family History 173  
      Type and Level of Sports Activity Performed 173  
      Physical Examination 173  
      Diagnostic Testing 174  
         12-Lead ECG 174  
         Echocardiography 174  
         Treadmill - Exercise - Testing 175  
         Cardiac Magnetic Resonance (CMR) 175  
         ECG Holter Monitoring 176  
         Laboratory Results 177  
      Diagnosis and Recommendations 177  
      Discussion 177  
  Reference 177  
  25 A Young Rower with an Unusual Left Ventricular Hypertrophy 178  
      Family and Personal History 178  
      Physical Examination 178  
      12-Lead ECG 178  
      Echocardiography 178  
      Exercise Testing 179  
      Detraining 180  
      Clinical Course 181  
      Additional Diagnostic Testing 181  
      Diagnosis and Recommendations 182  
      Discussion 184  
  References 185  
  26 An Elite Athlete with Controversial Left Ventricular Hypertrophy 186  
      Medical History 186  
      Physical Examination 186  
      12-Lead ECG 186  
      Echocardiography 186  
      Clinical Course 187  
      Diagnosis and Recommendations 190  
      Discussion 191  
  References 192  
  27 A Non-compaction Cardiomyopathy or Innocent LV Trabeculation? 194  
      Medical History 194  
      Family and Personal History 194  
      Physical Examination 194  
      12-Lead ECG 194  
      Exercise Testing 195  
      24-h ECG Holter Monitoring 195  
      Signal Averaging ECG 195  
      Echocardiography 196  
      Cardiac Magnetic Resonance (CMR) 197  
      Diagnosis and Recommendations 197  
      Discussion 198  
  References 199  
  28 A 31-Year-Old Male, Recreational Soccer Player with 0Low Risk0 Hypertrophic Cardiomyopathy 202  
      Medical History 202  
      Physical Examination 202  
      12-Lead ECG 202  
      Echocardiography 202  
      Exercise Testing 203  
      ECG Holter Monitoring 203  
      Diagnosis and Recommendations 203  
      Clinical Course 204  
      Autopsy Findings 204  
      Discussion 205  
  References 206  
  29 Competitive Cyclist Suffering from Myocardial Infarction, Willing to Resume Competitive Sport 207  
      Family and Personal History 207  
      Athletic History 207  
      Medical History 207  
      Reason for Cardiovascular Evaluation 209  
      Physical Examination 209  
      12-Lead ECG 209  
      Evaluation and Risk Stratification 209  
      Diagnostic Testing 209  
      Recommendations 211  
      Discussion 211  
  References 212  
  30 A 32 Year-Old Male Soccer Player with Chest Trauma 213  
      Medical History 213  
      Physical Examination 213  
      12-Lead ECG 213  
      Clinical Course 213  
      Cardiac Evaluation in the CCU 213  
      Additional Testing 215  
      Recommendations 215  
      Discussion 215  
  References 215  
  31 Asymptomatic Cyclist with Stenosis of Left Main Coronary Artery 217  
      Medical History 217  
      Physical Examination 217  
      12-Lead ECG 217  
      Exercise Testing 217  
      Additional Testing 217  
      Diagnosis and Recommendations 218  
      Discussion 220  
  References 221  
  Appendices 222  
  Index 237  


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