Severe Left Ventricular Dilation With Preserved Contractile Reserve in an Adolescent Elite Athlete

Figures

• 

  Visual Summary. Shared Decision-Making Framework for Elite Athletes With Dilated Cardiomyopathy Evaluation begins with symptom identification and structured risk stratification (history, ECG, imaging, exercise, and genetic testing). A multidisciplinary discussion involving the athlete, family, and specialists emphasizes autonomy, harm reduction, and transparency. Ongoing safety measures include longitudinal surveillance, emergency action planning, AED access, and CPR training for staff. AED = automated external defibrillator; CPR = cardiopulmonary resuscitation; ECG = electrocardiogram; MRI = magnetic resonance imaging.

• 

  Figure 1. 12-Lead Electrocardiogram The resting 12-lead electrocardiogram demonstrates normal sinus rhythm with a ventricular rate in the mid 60s. QRS complexes are narrow without bundle branch block. There is evidence of voltage criteria for left ventricular hypertrophy with associated repolarization abnormalities, including mild ST-segment elevation and T-wave prominence in the anterolateral precordial leads consistent with an early repolarization pattern. No pre-excitation is observed. There is no active atrial fibrillation at the time of this tracing.

• 

  Figure 2. Cardiac Magnetic Resonance With Late Gadolinium Enhancement in Short-Axis and Long-Axis Views Images demonstrate severe left ventricular dilation with global hypokinesis and absence of late gadolinium enhancement, consistent with a nonischemic dilated cardiomyopathy phenotype without myocardial fibrosis or scar.