Aortic Regurgitation and Progressive Left Ventricular Dilation in a Professional Hockey Player

Figures

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  Visual Summary. Clinical Trajectory of a Male Professional Ice Hockey Player With Bicuspid Aortic Valve, Moderate AR, and LV Dilation AR = aortic regurgitation; LV = left ventricular; LVIDd = left ventricular internal dimension at end-diastole; PPCS = preparticipation cardiovascular screening; SDM = shared decision-making; TTE = transthoracic echocardiography.

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  Figure 1. Findings on 12-Lead Electrocardiogram Electrocardiogram demonstrated sinus bradycardia, mild intraventricular conduction delay (QRS interval: 119 ms), short PR interval (113 ms) without pre-excitation, early repolarization of the anterior lead, and precordial lead voltage criteria for left ventricular hypertrophy.

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  Figure 2. Representative Images From Transthoracic Echocardiography Transthoracic echocardiography demonstrated left ventricular dilation with an end-diastolic diameter of 67 mm (A), moderate aortic regurgitation as demonstrated by color Doppler (B) and pulse-wave Doppler (C, pressure half-time of 399 ms), and normal left ventricular diastolic function measured using tissue Doppler imaging (D, lateral E′ = 15 cm/s).

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  Figure 3. Representative Cardiac MRI Images Cardiac MRI confirmed a maximal end-diastolic diameter of 66 mm as measured on the 3-chamber long-axis plane (A), and concomitant left and right ventricular dilation (B). MRI = magnetic resonance imaging.

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  Figure 4. Conventional 9-Panel Data From an Upright Cycle Ergometer Cardiopulmonary Exercise Test Continuous incremental 30 W/min ramp protocol to exhaustion.