Episode Details

A 22 year old soccer player with no symptoms walks into a clinic for a routine sports physical and walks out being told to quit his sport.

Dr. Baraki takes this mystery case blind and we hand him the pieces one at a time: the EKG, the echocardiogram, the cardiac MRI, the Holter monitor, the treadmill test and the genetic panel. Half of them come back completely normal. Play along and commit to an answer before the reveal, because there is a point in this case where most people would change theirs.

Then, the discussion about whether the restriction he was given was the right call, what the evidence on that says today compared with what it said for the previous 40 years, and why two doctors looking at the same numbers can reasonably land in different places.

And then screening. Should an EKG should be mandatory for amateur athletes? All this and more, on this episode of the Barbell Medicine Podcast.

Timestamps

• 00:00 A 22-year-old needs a form signed
• 02:16 The history and exam
• 05:49 Reading his EKG 
• 13:13 The echo and the MRI
• 18:26 The rest of the workup, and Austin commits to a diagnosis
• 24:02 Patient course
• 27:54 What his care team decided
• 29:45 How much the heart changes with training
• 36:45 A second case that went differently
• 41:52 Should a finding like this end a career
• 45:47 Should an EKG be mandatory for amateur athletes
• 55:59 What would actually move the needle

Resources

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