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A Journal on Sports Medicine

Official Journal of the Italian Sports Medicine Federation
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Medicina dello Sport 2015 March;68(1):113-9


language: English, Italian

Ostium sinus venosus atrial septal defect in a young athlete: the role of the electrocardiogram and auscultation

Ciccarone G. 1, Bilardo G. 2, Martelli G. 3, Ismael M. 1, Scalchi G. 2, Gioffredi A. 1, Bonso A. 2

1 Servizio di Medicina dello Sport, Unità Operativa Complessa di Cure Primarie, ULSS 2 di Feltre, Belluno, Italia; 2 Unità Operativa Complessa di Cardiologia, ULSS 2 di Feltre, Belluno, Italia; 3 Centro Medico e Riabilitativo Performance, Siena, Italia


Sinus venosus atrial septal defect (ASD) is a rare congenital heart condition which is often associated with partial anomalous pulmonary venous return: pulmonary hypertension is the principal clinical consequence if this heart defect is not surgically corrected. The clinical case presented here deals with an 11-year-old male athlete, who came under our observation, together with his twin brother, for a first check-up to be declared medically fit to play sport at a competitive level. The athlete was asymptomatic, with no family history of cardio-respiratory diseases and cardio-respiratory examination at rest proved normal. Decisive for the request for second level tests was the basic electrocardiogram, which presented a right ventricular conduction delay of the incomplete right bundle branch block type, with rsR’ pattern in lead V1 and auscultation, performed systematically in the first phase of recovery after the stress test, which showed a grade 2/6 systolic ejection murmur at the left sternal border, more evident in the third and fourth left intercostal space, which extended to the midaxillary line. The echocardiography documented a high atrial septal defect, possibly superior vena cava type sinus venosus defect, with minus 9-10 mm and with signs of volume overload of the right sections. Following cardiology and cardiac surgical assessment it was decided to perform corrective surgery. The clinical case showed that, even to diagnose a rare and complex disease, during a first level check-up to be declared fit for competitive sports, at times the accurate analysis of the basic electrocardiogram and cardiac auscultation within the first minute from the end of the stress test can suffice.

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Cite this article as

Ciccarone G, Bilardo G, Martelli G, Ismael M, Scalchi G, Gioffredi A, et al. Ostium sinus venosus atrial septal defect in a young athlete: the role of the electrocardiogram and auscultation. Med Sport 2015 March;68(1):113-9. 

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