Pediatric sports cardiology and CMR: athlete or pathology and can they play?-Pediatric sports cardiology and CMR: athlete or pathology and can they play?

Video Transcription

Video Summary

This webinar focused on the overlap between congenital cardiology and sports cardiology, especially how to evaluate athletes at risk for sudden cardiac death. Dr. Martinez introduced exercise-induced cardiovascular remodeling and emphasized the value of multimodality imaging, particularly cardiac MRI, for distinguishing physiologic athlete’s heart from disease and for risk stratification using late gadolinium enhancement and extracellular volume.<br /><br />Two cases were discussed. The first was a 14-year-old boy who collapsed during basketball and was found to have ventricular tachycardia, mild-to-moderate septal hypertrophy, abnormal ECG changes, and a small area of myocardial scar on MRI, concerning for evolving hypertrophic cardiomyopathy despite negative genetic testing. The panel discussed how MRI, exercise testing, and age-specific interpretation of wall thickness help distinguish athlete’s heart from pathology, and how management should involve shared decision-making, emergency planning, AED access, and ICD placement. They also addressed return-to-play decisions and the challenges of continuing sports into college.<br /><br />The second case involved a 22-year-old athletic man with exertional chest pain, abnormal ECG, and biventricular dilation on echo, later diagnosed by MRI with congenital pericardial agenesis. The experts highlighted how MRI clarifies anatomy, rules out scar or other pathology, and supports ongoing participation with surveillance rather than restriction.<br /><br />Overall, the webinar stressed careful imaging interpretation, individualized counseling, and shared decision-making in young athletes with cardiac abnormalities.

Keywords

congenital cardiology

sports cardiology

sudden cardiac death

cardiac MRI

athlete's heart

hypertrophic cardiomyopathy

late gadolinium enhancement

pericardial agenesis

shared decision-making