Literature Review: syncope evaluation in a young athlete, a review of normal vs abnormal ECG in athletes

Emergency Cardiology Literature Review & Updates with Dr. Amal Mattu


A 22-year-old male college basketball player presents to the ED after a syncopal episode during a late morning practice. Witnesses state that he shook for a few seconds but did not have a post-ictal period. He did not eat breakfast and had minimal fluid intake before practice. He reports feeling lightheaded and short of breath for a few seconds before the episode. He is now asymptomatic and has no significant past medical or family history. The following ECG is obtained:

Before watching this week’s video, ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. What is your differential diagnosis for patients with syncope, when history and physical exam do not suggest an obvious diagnosis?
  3. What is considered to be a normal ECG for an athlete?
  4. What is considered to be an abnormal ECG for an athlete?
  5. How would you manage this patient?