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The World in Medicine
August 9, 2000

ECG Limitations

JAMA. 2000;284(6):686. doi:10.1001/jama.284.6.686

As athletes worldwide prepare for the 2000 Olympic Games in Sydney, Australia, researchers in Italy have sounded a note of cardiac caution. Electrocardiograms (ECGs) may detect abnormalities in an athlete's highly conditioned heart muscle that aren't necessarily signs of disease.

"Athletic conditioning is responsible for lots of changes in an athlete's ECG," Antonio Pelliccia, MD, of the Institute of Sports Science in Rome, explained. During a 2-year study, Pelliccia and colleagues compared the results of echocardiograms and ECGs in 1005 competitive athletes. While the echocardiograms revealed abnormalities in 5% of the athletes tested, ECGs were distinctly or mildly abnormal in 40% of the athletes. Distinct abnormalities consisted mainly of indications of enlarged left ventricles and increased thickness in the heart wall. Athletes with these results commonly participated in endurance sports—rowing, cycling, and long-distance running. But follow-up tests over a 3-year period showed these athletes had no structural malformations in their hearts.