Pre-excitation and conduction abnormalities

Ventricular pre-excitation (Wolff–Parkinson–White pattern) and conduction abnormalities may be discovered during cardiovascular pre-participation screening in athletes. Their prevalence varies between 0.1% (Wolff–Parkinson–White, left bundle branch block) and 1% (right bundle branch block). Patients with pre-excitation and paroxysmal palpitations need to be treated before considering their eligibility to participate in sport. An electrophysiological study is required in asymptomatic athletes with the Wolff–Parkinson–White pattern. Subjects are considered ineligible for participation in sport if the RR intervals between pre-excited complexes during induced atrial fibrillation are <250ms. Subjects with conduction abnormalities may or may not be affected by heart disease. In the absence of heart disease, athletes with first- or second-degree atrioventricular (AV) block which normalizes during effort are eligible to participate in sport. According to current Italian and US guidelines, athletes with right bundle branch block, left anterior hemiblock, left posterior hemiblock, and left bundle branch block can participate in all sports in the absence of heart disease (including genetic Lenègre disease) and no episodes of AV block.

Myocarditis case associated with Campylobacter jejuni

Objective Myocarditis is an inflammatory disease of the heart caused by various agents and especially enteroviruses, and it is difficult to diagnose and treat. Myocarditis is rarely associated with bacterial infections. Although the most common bacterial infections are Salmonella spp. and Shigella spp., extremely rare cases of Myocarditis due to Campylobacter jejuni are also reported. Patient and methods A 17-year-old male patient with no previous chronic illness was admitted to our emergency department with complaints of abdominal pain, diarrhea, vomiting, and chest pain. He stated that symptoms began after eating a chicken burger a few days ago. Results In the laboratory tests performed, CK-MB and high sensitive Troponin I values were determined as 33.8 IU/L and 1816 ng/L, respectively. Electrocardiogram results revealed left axis left anterior hemiblock in the normal sinus rhythm as well as a ST-T change in the inferior and lateral derivations. Campylobacter jejuni was detected in the stool sample of the patient. Conclusion Myocarditis is one of the rare complications of C. jejuni infection. Bacterial myocarditis should be considered when troponin and cardiac enzymes are elevated in patients admitted to the emergency department with diarrhea and chest pain.