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European Journal of Echocardiography Advance Access originally published online on August 18, 2008
European Journal of Echocardiography 2009 10(1):151-153; doi:10.1093/ejechocard/jen219
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org.

Hypertrophic cardiomyopathy and athlete's heart: a tale of two entities

María Martín*, José Julián Rodríguez Reguero*, Mónica García Castro, Eliécer Coto, Ernesto Hernández, Amelia Carro, David Calvo and César Morís de la Tassa

Area del Corazón y Departamento de Genética Molecular del Hospital Universitario Central de Asturias, Calle Julián Clavería s/n, 33006 Oviedo, Spain

Received 25 May 2008; accepted after revision 27 July 2008; online publish-ahead-of-print 18 August 2008.

* Corresponding author. Tel: +34 985 10 80 00 36173. E-mail address: josejucasa{at}yahoo.es and jjcasa{at}elcastromocho.com


  Abstract

Sudden death during sports activities, although unfrequent, is a tragic event with great impact on both the general and medical communities. The two commonest conditions leading to sudden cardiac death in young athletes are hyperthrophic cardiomyopathy (HCM), the main cause in the USA, and arrythmogenic right ventricular cardiomyopathy, which is the leading cause in Europe.

We report the case of a 17-year-old football player with a pathological electrocardiography (ECG) in the pre-participation screening programme, highly suggestive of HCM, in which ECG study showed a septum thickness of 28 mm. Genetic analysis revealed R 495 W mutation in the 18 exon of the MyBPC3 (myosin-binding protein C) and sports activities were contraindicated. Two years later, septum thickness was 19.5 mm. Usefulness of 12-lead ECG, differential diagnosis between athlete's heart and HCM, and the stratification in patients with HCM are discussed.

Keywords: Hypertrophic cardiomyopathy; Athlete's heart; Pre-participation screening programme


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