{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T13:08:53Z","timestamp":1778764133275,"version":"3.51.4"},"reference-count":40,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>A 36-year-old professional marathon runner reported sudden irregular palpitations occurring during competitions, with heart rates (HR) up to 230 bpm recorded on a sports HR monitor (HRM) over 4 years. These episodes subsided upon the cessation of exercise. Electrocardiograms, echocardiography, and cardiac magnetic resonance imaging results were borderline for athlete\u2019s heart. Because an electrophysiology study and standard exercise tests provoked no arrhythmia, doctors suspected Munchausen syndrome. Ultimately, an exercise test that simulated the physical effort of a competition provoked tachyarrhythmia consistent with the HRM readings. This case demonstrates the diagnostic difficulties related to exercise-induced arrhythmia and the diagnostic usefulness of sports HRMs.<\/jats:p>","DOI":"10.3390\/diagnostics13182917","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T04:38:48Z","timestamp":1694493528000},"page":"2917","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Exercise-Induced Arrhythmia or Munchausen Syndrome in a Marathon Runner?"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8305-8130","authenticated-orcid":false,"given":"Robert","family":"Gajda","sequence":"first","affiliation":[{"name":"Center for Sports Cardiology at the Gajda-Med Medical Center in Pu\u0142tusk, ul. Piotra Skargi 23\/29, 06-100 Pu\u0142tusk, Poland"},{"name":"Department of Kinesiology and Health Prevention, Jan Dlugosz University, 42-200 Czestochowa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wojciech","family":"Drygas","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Lazarski University, ul. Swieradowska 43, 02-662 Warsaw, Poland"},{"name":"National Institute of Cardiology, ul. Alpejska 42, 04-628 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacek","family":"Gajda","sequence":"additional","affiliation":[{"name":"Center for Sports Cardiology at the Gajda-Med Medical Center in Pu\u0142tusk, ul. Piotra Skargi 23\/29, 06-100 Pu\u0142tusk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5990-5734","authenticated-orcid":false,"given":"Pawel","family":"Kiper","sequence":"additional","affiliation":[{"name":"Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Venice, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2412-9103","authenticated-orcid":false,"given":"Beat","family":"Knechtle","sequence":"additional","affiliation":[{"name":"Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland"},{"name":"Medbase St. Gallen Am Vadianplatz, 9000 St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4547-5627","authenticated-orcid":false,"given":"Magdalena","family":"Kwa\u015bniewska","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Faculty of Health Sciences, Medical University of Lodz, ul. Lucjana \u017beligowskiego 7\/9, 90-752 \u0141\u00f3d\u017a, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maciej","family":"Sterli\u0144ski","sequence":"additional","affiliation":[{"name":"National Institute of Cardiology, ul. Alpejska 42, 04-628 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"El\u017cbieta Katarzyna","family":"Biernacka","sequence":"additional","affiliation":[{"name":"National Institute of Cardiology, ul. Alpejska 42, 04-628 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Graziano, F., Juhasz, V., Brunetti, G., Cipriani, A., Szabo, L., Merkely, B., Corrado, D., D\u2019ascenzi, F., Vago, H., and Zorzi, A. (2022). May Strenuous Endurance Sports Activity Damage the Cardiovascular System of Healthy Athletes? A Narrative Review. J. Cardiovasc. Dev. 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