What does this research mean for the field?

A 38-year-old recreational athlete with hypertrophic cardiomyopathy has a 5.73% five-year risk of sudden cardiac death, leading to the implantation of a subcutaneous ICD. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To assess the risk and management options for a recreational athlete with hypertrophic cardiomyopathy.

January 10, 2026European Heart Journal - Case ReportsOpen Access

A Case Report in Hypertrophic Cardiomyopathy in a Recreational Athlete: Multimodality Risk Assessment, Genetic Insights, and Shared Decision-Making

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Key result

Subcutaneous ICD manages a ~6% five-year SCD risk in a recreational athlete with HCM.

Why the study?

Sports participation in patients with inherited cardiac conditions remains a major challenge, particularly when balancing arrhythmic risk against quality of life.

Key Points

To assess the risk and management options for a recreational athlete with hypertrophic cardiomyopathy.
Conducted a comprehensive cardiac assessment including ECG, echocardiography, and stress testing
Utilized cardiac magnetic resonance imaging and Holter monitoring for detailed analysis
Performed genetic testing to identify pathogenic variants
Employed ESC and AHA/ACC calculators for risk stratification
Engaged in shared decision-making regarding ICD implantation
Identified asymmetric non-obstructive hypertrophic cardiomyopathy with significant late gadolinium enhancement
Found a 5.73% five-year risk of sudden cardiac death
Implanted a subcutaneous ICD to manage arrhythmic risk while allowing continued recreational sports participation

Structured PICO

Population

n=1, 38-year-old recreational athlete diagnosed with asymmetric non-obstructive hypertrophic cardiomyopathy (HCM) with extensive late gadolinium enhancement and two missense variants in MYBPC3.

Intervention

Subcutaneous implantable cardioverter-defibrillator (ICD) implantation

Multimodal imaging, genetic testing, and guideline-based risk stratification can effectively guide individualized management and safe recreational sports participation in athletes with hypertrophic cardiomyopathy.

Implication

Guides individualized ICD decisions via ESC scoring in athletic HCM; leaves open prospective validation for sports safety.

Abstract

Background Sports participation in patients with inherited cardiac conditions remains a major challenge, particularly when balancing arrhythmic risk against quality of life. Case Summary A case of a 38-year-old recreational athlete diagnosed with hypertrophic cardiomyopathy (HCM) is described. A comprehensive assessment was performed, including ECG, echocardiography, exercise stress testing, Holter monitoring, and cardiac magnetic resonance (CMR), which revealed asymmetric non-obstructive HCM with extensive late gadolinium enhancement. Genetic testing identified two missense variants in MYBPC3, one of which was reclassified as likely pathogenic. Risk stratification using ESC and AHA/ACC calculators demonstrated a 5.73% five-year risk of sudden cardiac death (SCD). A subcutaneous implantable cardioverter-defibrillator (ICD) was implanted after a shared decision-making process, allowing the patient to continue recreational sport while avoiding competitive athletics. Discussion This case highlights the value of multimodal imaging, genetic testing, and guideline-based SCD risk stratification in guiding individualized management of athletes with HCM.

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Cite This Study

Gomez et al. (2025) studied this question. A 38-year-old recreational athlete with hypertrophic cardiomyopathy was assessed, yielding a 5.73% five-year risk of sudden cardiac death, leading to ICD implantation.

synapsesocial.com/papers/6963223891e05aa366cb8d5c https://doi.org/10.1093/ehjcr/ytaf671