A diagnostic dilemma in non-compaction, resulting in near expulsion from the Football World Cup

Abstract

Left ventricular non-compaction is a cardiac abnormality whose echocardiographic diagnostic criteria are still controversial. The distinction between normal and pathologic is additionally impeded by the fact that the left ventricular myocardium is more intensively trabeculated in African blacks than in Caucasians. The impact of these uncertainties and unresolved issues in the diagnosis of non-compaction is illustrated by a 23-year-old professional African footballer in whom an aberrant left ventricular band was misinterpreted as non-compaction. The diagnosis of non-compaction resulted in the immediate withdrawal of the playing licence and impending deportation of the young man from Germany to his home country. Organized by the footballer's lawyer, repeated echocardiographies and cardiac magnetic resonance imaging failed to diagnose non-compaction. After several months, the young man regained his playing licence and played as a striker in the national team of his country of origin in the football world cup. Uncertainties and unresolved issues may result in misdiagnosis of non-compaction, thus promoting discrimination and degradation. This case highlights the urgent need for standardization of diagnostic criteria for left ventricular non-compaction and to assess if they need to be different for African blacks and Caucasians.