Abnormal athlete ECG – echo — RACP Paediatrics MCQ

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ModerateCardiologyAbnormal athlete ECG – echoRACP Paediatrics

The same athlete's ECG shows T-wave inversion in V1-V4, deep S waves in V5-V6, and abnormal Q waves. What is the most appropriate next investigation?

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Correct answer: A — Echocardiogram

Pathological ECG findings in an athlete (T-wave inversion beyond V2 in >14 years, pathological Q waves, ST depression) require further investigation with echocardiography to assess for structural heart disease (HCM, ARVC, dilated cardiomyopathy). If echocardiography is abnormal or inconclusive, cardiac MRI provides superior tissue characterisation.

Reference: RCH Melbourne – 2023 – Sports Cardiology CPG; RACP Paediatric Curriculum – Cardiology