And The Beat Goes On: Return To Play In An Athlete With Cardiac Anomalies

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And The Beat Goes On: Return To Play In An Athlete With Cardiac Anomalies - Page #1

Author: Jared Roberts, MD Co Author #1: Jeffrey Mann, DO (Co-Author 1) Co Author #2: Mark Stovak, MD (Co-Author 2) Arthur Islas, MD (Co-Author 3) Senior Editor: Heather Rainey, MD Editor: Anthony Noll, DO, MHA Patient Presentation: A 20-year-old African American male football player was found to have an abnormal screening electrocardiogram in July of 2022. History: This electrocardiogram identified patterns concerning for hypertrophic cardiomyopathy, which prompted a cardiac workup with serial echocardiograms and deconditioned cardiac magnetic resonance imaging. The athlete's initial echocardiograms were unremarkable, but his magnetic resonance imaging revealed thickening of the basal septum without post-gadolinium enhancement. Given this concern for hypertrophic cardiomyopathy, the athlete was medically disqualified from sport for the 2022-23 season. In the Spring of 2023 the athlete was evaluated by a cardiologist at a tertiary referral center. They performed independent assessments, including repeat electrocardiograms, echocardiogram, and nuclear stress testing. These evaluations revealed a progression of T-wave inversions into the lateral leads on the athlete's electrocardiogram from March 2023 to May 2023, but did not reveal classic hypertrophic cardiomyopathy structural changes. Based on these results, with shared decision making between the athlete and his family, the cardiologist who assessed the athlete had recommended that he could return to play. Physical Exam: General Appearance: Alert, no distress Neck: No thyroid enlargement/tenderness/nodules; no carotid bruit Lungs: Clear to auscultation bilaterally, respirations unlabored Chest Wall: No tenderness or deformity Heart: Regular rate and rhythm, S1 and S2 normal, no murmur, rub or gallop Extremities: Extremities normal, atraumatic, no cyanosis or edema Pulses: 2+ and symmetric all extremities Skin: Skin color, texture, turgor normal, no rashes or lesions. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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