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Case Reports
. 2022 Dec 13:6:101705.
doi: 10.1016/j.jaccas.2022.101705. eCollection 2023 Jan 18.

Asymptomatic Apical Hypertrophic Cardiomyopathy in an Elite Competitive Athlete

Athena L Huang  1 , James MacNamara  1 , Mark S Link  1 , Matthew Martinez  2 , Joseph A Dearani  3 , Bryan C Cannon  3 , Benjamin D Levine  1 , Michael J Ackerman  3
Affiliations
Case Reports

Asymptomatic Apical Hypertrophic Cardiomyopathy in an Elite Competitive Athlete

Athena L Huang et al. JACC Case Rep. .

Abstract

A 17-year-old male elite athlete presented for evaluation after an abnormal pre-competitive college screening electrocardiogram. Subsequent evaluation revealed the presence of hypertrophic cardiomyopathy. He remained asymptomatic throughout four years of follow-up. Through shared decision making, he continued to play competitively and is now a professional athlete. (Level of Difficulty: Advanced.).

Keywords: CMR, cardiac magnetic resonance imaging; ECG, electrocardiogram; HCM, hypertrophic cardiomyopathy; ICD, implantable cardioverter defibrillator; LGE, late gadolinium enhancement; LVOT, left ventricular outflow tract; SCD, sudden cardiac death; SDM, shared decision making; TTE, transthoracic echocardiography; competitive athlete; hypertrophic cardiomyopathy; shared decision making.

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Conflict of interest statement

This work was supported by the Mayo Clinic Windland Smith Rice Comprehensive Sudden Cardiac Death Program (to Dr Ackerman). Dr Ackerman is a consultant for Abbott, Boston Scientific, Bristol Myers Squibb, Daiichi Sankyo, Invitae, LQT Therapeutics, Medtronic, and UpToDate, and with the Mayo Clinic has equity, intellectual property, or royalty relationships with AliveCor, Anumana, ARMGO Pharma, and Pfizer, none of which were involved in this manuscript in any way. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
12-Lead Electrocardiogram Normal sinus rhythm, voltage criteria for left ventricular hypertrophy, and deep T-wave inversions in leads II, III, aVF, and V3-V6. Note normalization of T-wave in lead aVR, which is classic in apical hypertrophic cardiomyopathy.
Figure 2
Figure 2
Cardiac Magnetic Resonance Imaging (A and C) Initial CMR showed a maximum wall thickness of 23 mm at the apical inferior region of the left ventricle and a total late gadolinium enhancement (LGE) volume of <5%. (B and D) Follow-up CMR 3 years later showed progression of hypertrophy with a maximum wall thickness of 28 mm and (E) a total LGE volume of 15%.
See this image and copyright information in PMC

References

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