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Minerva Ortopedica e Traumatologica 2018 September;69(3 Suppl 1):102-9

DOI: 10.23736/S0394-3410.18.03869-9


lingua: Inglese

Physical overexertion in a high-skilled female athlete: case report

Alexander ISAEV , Vitaly EPISHEV, Taniyana ALFYOROVA, Yuliya KORABLOVA

Institute of Sports, Tourism, and Service, South Ural State University, Chelyabinsk, Russia


The objective of this report is to analyze the clinical case of chronic physical overexertion in a high-skilled female athlete. We examined the member of the Russian national orienteering team in the Research center for Sport Science of the South Ural State University. She complained of an intermittent headache during trainings and decrease of endurance. We examined the patient using the following methods: Holter monitor, echocardiography, rest electrocardiography, electrocardiography with physical load, clinical urine and blood test, body composition test. We established that 5 months before the manifestation of symptoms of physical overexertion the athlete performed the following training load: running - 486 km, bicycle - 907 km, ski-rollers - 529 km. In March 2015, the Holter monitor was conducted establishing the rhythm disturbance of a rare type of single supraventricular extrasystoles and rare isolated monotonous ventricular extrasystoles of I grade according to the Lown’s classification. The electrocardiography with physical load revealed the episodes of ST-segment depression (downsloping) up to 2 mm. The data obtained with echocardiography, clinical urine and blood test did not reveal any deviations. We recommended to the athlete to stop training loads for 3 months and prescribed drug therapy. Month later we examined the patient using veloergometer and registered ST segment downsloping depression with a bulge to the top forming negative T-wave in II, III, aVF leads and in leads from V3 to V6. The test with physical load was limited by the stopping criteria. In May 2015, we examined the patient for the second time using veloergometer. The analysis of VEM dynamics showed the increase in tolerance to physical load and the absence of rhythm and conduction disturbance with 3-minute recovery period in terms of HR and BP and 5-minute recovery period in terms of the electrocardiography. The clinical case described is a typical example of the peculiarities of this professional group. The athletes accustom to overcome physical exertion and pain and postpone visiting a doctor. It can be the possible predictor of sudden cardiac death. Thus, the present clinical case demonstrates unexpected difficulties in the treatment of chronic physical overexertion of athletes, which require completely different organization of the treatment process.

KEY WORDS: Sport - Athletes - Physical exertion

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