1 A 24-year-old middle-distance runner experiences a syncope during interval training; during a 400-m run at maximal speed he falls and is unconscious for a couple of minutes before he wakes up and feels quite OK apart from a hurting arm. Which (one or more) of the following statements is/are correct?
a Syncope during exercise is normal and no further investigation is warranted.
b Syncope during exercise only needs investigation if it happens more than once.
c Syncope during exercise may be a sign of life-threatening disease and the patient should be promptly investigated.
2 Which (one or more) of the following statements about ECG and echocardiography findings in endurance-trained athletes is/are normal findings:
a first-degree atrioventricular block b low resting heart rate, below 40 beats/min c large QRS amplitudes and high T waves d slightly enlarged left ventricle on echocardiography.
3 A strength-training athlete is investigated because of fatigue over the last few months. Echocardiography shows a left ventricle diameter of 40 mm and a thickness of the posterior and septal wall of18-ig mm. There is normal left ventricular function. Which (one or more) of the following statements is/are correct?
a This is a normal finding.
b The left ventricular walls are thick but this is normal finding in a strength-trained athlete. c The LV hypertrophy in this athlete is probably a pathologic finding and further investigation is warranted.
4 An otherwise healthy patient with treated essential hypertension wants to start jogging. Which (one or more) of the following statements is/are correct?
a Exercise in contraindicated as it may be harmful. b Moderate aerobic training is recommended. c Moderate aerobic training is recommended but only once a week.
d Exercise a few times a week may reduce resting systolic blood pressure by 10 mmHg.
a Not allowed because of risk of arrhythmias. b Leads to increased exercise ability and V^. c Improves the prognosis. d Improves blood lipid status.
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