Case Session 02: Non-ischemic Cardiomyopathies (2018)-Athlete’s Heart or Hypertrophic Cardiomyopathy?

Athlete’s Heart or Hypertrophic Cardiomyopathy?

Video Transcription

Video Summary

A 28-year-old professional weightlifter with palpitations and a family history of sudden cardiac death was initially thought to have athlete’s heart, HCM, or a channelopathy. Early echo was normal, but CMR showed subtle HCM markers: borderline septal thickening, elongated mitral valve leaflet, abnormal papillary muscles, and trabeculation. Five years later, symptoms worsened and imaging showed progression to asymmetric hypertrophy with patchy late gadolinium enhancement. Holter monitoring revealed nonsustained monomorphic ventricular tachycardia. Using CMR rather than echo increased his HCM sudden death risk score, changing ICD consideration from “may be considered” to “should be considered.”

Keywords

hypertrophic cardiomyopathy

cardiac magnetic resonance

sudden cardiac death

ventricular tachycardia

implantable cardioverter defibrillator