CASE REPORT

Physiological left ventricular hypertrophy or hypertrophic cardiomyopathy in an elite adolescent athlete: role of detraining in resolving the clinical dilemma

S Basavarajaiah¹, M Wilson², S Junagde¹, G Jackson¹, G Whyte², S Sharma¹

¹ University Hospital of Lewisham, London, UK
² Olympic Medical Centre, Northwick Park Hospital, Watford, Middlesex, UK

Correspondence to:
Correspondence to:
Dr Sharma
Department of Cardiology, University Hospital of Lewisham, Lewisham High Street, London SE13 6LH, UK; ssharma21{at}hotmail.com

The differentiation of physiological left ventricular hypertrophy (LVH) from hypertrophic cardiomyopathy (HCM) can prove challenging for even the most experienced cardiologists. The case is presented of a 17 year old elite swimmer who had electrocardiographic and echocardiographic features that were highly suggestive of HCM. However, indices of diastolic function were normal and cardiopulmonary exercise testing revealed high peak oxygen consumption in keeping with physiological LVH. To resolve the diagnostic dilemma, the patient underwent detraining for eight weeks, after which, there was complete resolution of the changes seen on electrocardiogram and echocardiogram, indicating physiological LVH rather than HCM.

Abbreviations: ECG, electrocardiogram; HCM, hypertrophic cardiomyopathy; LVH, left ventricular hypertrophy

Keywords: hypertrophic cardiomyopathy; detraining; elite adolescent athlete; left ventricular hypertrophy

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Commentary

W O Roberts³

³ University of Minnesota Medical School, Minneapolis, Minnesota, USA; rober037{at}umn.edu

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