Electrocardiograma en el atleta pediátrico: adaptaciones fisiológicas, hallazgos borderline y criterios de alarma

Alan García Yánez; Miguel Mateo Montañez Soler; Kevin Villa Lopera; Hernando Baquero Aguilera

doi:10.47487/apcyccv.v7i2.626

Autores/as

Alan García Yánez Shizo Sports Medicine, División de Medicina del Deporte y Actividad Física, Bogotá, Colombia. https://orcid.org/0000-0002-1560-5403
Miguel Mateo Montañez Soler Fortaleza Fútbol Club, División de Medicina del Deporte y Actividad Física, Bogotá, Colombia. https://orcid.org/0009-0007-4056-4977
Kevin Villa Lopera Independiente Yumbo Fútbol Club, División de Medicina del Deporte y Actividad Física, Yumbo, Colombia. https://orcid.org/0009-0000-1704-6775
Hernando Baquero Aguilera Shizo Sports Medicine, División de Medicina del Deporte y Actividad Física, Bogotá, Colombia. https://orcid.org/0009-0004-4207-3424

DOI:

https://doi.org/10.47487/apcyccv.v7i2.626

Palabras clave:

Ejercicio Físico, Electrocardiografía, Estratificación del Riesgo, Muerte Súbita Cardíaca, Pediatría

Resumen

La interpretación del electrocardiograma (ECG) en el atleta pediátrico representa un desafío clínico debido a la interacción entre los procesos de crecimiento cardiovascular, la maduración electrofisiológica y las adaptaciones inducidas por el entrenamiento físico. A diferencia del adulto, el fenotipo eléctrico en niños y adolescentes refleja un sistema en evolución, lo que condiciona una mayor variabilidad en los patrones electrocardiográficos observados. La correcta diferenciación entre hallazgos relacionados con el desarrollo, adaptaciones fisiológicas al ejercicio y alteraciones sugestivas de cardiopatía estructural o eléctrica resulta fundamental para optimizar la detección precoz de enfermedades cardiovasculares relevantes y evitar restricciones innecesarias de la práctica deportiva. Este artículo revisa los fundamentos electrofisiológicos del ECG en el atleta juvenil y propone una clasificación clínica de los hallazgos en fisiológicos, borderline y anormales, integrando criterios contemporáneos de interpretación. Se presenta, además, un enfoque práctico para la interpretación clínica del ECG y la indicación racional de estudios complementarios, con el objetivo de mejorar la precisión diagnóstica y favorecer una práctica deportiva segura en la población pediátrica.

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