Key result
Multimodality screening helps differentiate apicolateral bulge from ARVC to guide risk stratification in athletes.
Why the study?
Preparticipation screening seeks to detect cardiovascular conditions predisposing young athletes to sudden cardiac death, where exercise-induced cardiac remodeling and T-wave inversions can raise concern for ARVC.
Case Report (n=1)
An apicolateral bulge can mimic ARVC in athletes, highlighting the importance of multimodality imaging in preparticipation cardiovascular screening.
May aid differentiation of benign variants from ARVC in athletes; leaves open need for prospective validation before changing screening practice.
Soccer is the most popular sport in the world, with over 265 million active players and approximately 0.05% professional players worldwide. The Fédération Internationale de Football Association (FIFA) has made preparticipation screening recommendations which involve electrocardiography and echocardiography being performed prior to international competition. The aim of preparticipation cardiovascular screening in young athletes is to detect asymptomatic individuals with cardiovascular disease at risk of sudden cardiac death (SCD). The incidence of SCD in young athletes (age≤ 35 years) is 0.6-3.6 in 100,000 persons/year, with most deaths due to cardiovascular causes. Arrhythmogenic right ventricular cardiomyopathy (ARVC) is one of the leading causes of SCD in young athletes. It is a genetic disease characterized by progressive fibrofatty replacement of the myocardium with variable phenotypic expression. Exercise-induced cardiac remodeling in conjunction with extensive T-wave inversion raises concern for ARVC. This case report and literature review explores a potential mimic for ARVC, the role of cardiovascular screening in sport, and the use of a multimodality approach for risk stratification and management.
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Richard P. Allwood (2024) conducted a case report in Arrhythmogenic right ventricular cardiomyopathy (ARVC) mimic (n=1). Multimodality cardiovascular screening was evaluated. A multimodality approach to cardiovascular screening in athletes can help differentiate an apicolateral bulge from arrhythmogenic right ventricular cardiomyopathy to guide risk stratification.
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