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THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

Rivista di Medicina, Traumatologia e Psicologia dello Sport


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Case report  


The Journal of Sports Medicine and Physical Fitness 2001 Giugno;41(2):275-7

lingua: Inglese

Fortuitously discovered persistent left superior vena cava in young competitive athletes. Clinical implications of sports physicians

Kinoshita N., Hasegawa K. *, Oguma Y., Katsukawa F., Onishi S., Yamazaki H.

From the Sports Medicine Research Center Keio University, Yokohama, Kanagawa, Japan
* Yokohama Heart Cener


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This ­report ­describes two ath­letes ­with per­sis­tent ­left super­i­or ­vena ­cava (­PLSVC) acci­den­tal­ly iden­ti­fied dur­ing prep­ar­tic­i­pa­tion med­i­cal eval­u­a­tion. The clin­ical impli­ca­tions of ­PLSVC for ­sports phy­si­cians are ­also dis­cussed. A 16-­year-old ­male ice hock­ey ­player and an 18-­year-old ­male ­high-lev­el ­field hock­ey ­player vis­it­ed our insti­tute for med­i­cal eval­u­a­tion ­prior to par­tic­i­pat­ing in com­pe­ti­tion. Neither com­plained of pal­pi­ta­tion, faint­ness or syn­cope, ­which ­would ­have sug­gest­ed a pos­sible car­diac ­rhythm dis­tur­bance, or had ­been ­informed of any abnor­mal­ities in pre­vi­ous phys­i­cal exam­ina­tions. Nonetheless, ech­o­car­di­og­ra­phy ­revealed dilat­ed cor­o­nary sinus­es, and venog­ra­phy con­firmed ­PLSVC and, in one ­case, ­showed the ­absence of the ­right super­i­or ­vena ­cava. Electrocardiograms ­showed the ­field hock­ey ­player to ­have an ectop­ic atri­al ­rhythm ­with ­left ­axis devi­a­tion of the fron­tal ­plane P-­wave and the ice hock­ey ­player to ­have nor­mal ­sinus ­rhythm. Symptom-lim­it­ed tread­mill test­ing ­revealed noth­ing abnor­mal, and ­after explain­ing the pos­sible ­rhythm instabil­ity and the poten­tial ­risk asso­ciat­ed ­with car­diac sur­gery, the sub­jects ­were per­mit­ted ­full par­tic­i­pa­tion in com­pet­i­tive ­sports. Although infor­ma­tion is ­scarce, avail­able ­data on ­PLSVC sug­gest it is ­benign for com­pet­i­tive ath­letes. Nevertheless, com­pli­ca­tions aris­ing ­from oth­er car­di­o­vas­cu­lar anom­a­lies, ­from poten­tial car­diac ­rhythm dis­tur­banc­es, and ­from car­diac sur­gery neces­si­tat­ed by ­major inju­ries ­should be con­sid­ered ­prior to par­tic­i­pa­tion in com­pet­i­tive ­sports.

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