An athlete’s heartache

Clinical scenario

A 25-YEAR-OLD male first-grade rugby player has been asked by his team doctor to have a routine ECG performed prior to commencing playing this season. The above ECG is recorded while he is at rest and looking well.

On further questioning, he does not have any significant past cardiac history, but more recently he has noticed occasional palpitations. He denies any syncope, although once after training he felt