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This case study highlights a recreational sportsman with a mild form of noncompaction cardiomyopathy (NCCM), presenting with ventricular extrasystoles. Despite asymptomatic findings, cardiac insufficiency treatment and family screening are recommended.

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Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Genetics

Background:

  • Noncompaction cardiomyopathy (NCCM) is a rare congenital heart disease characterized by excessive myocardial trabeculation.
  • Patients often present with heart failure, arrhythmias, or thromboembolic events, with sudden cardiac death being a leading cause.

Observation:

  • A 47-year-old sportsman with good physical performance was found to have polymorphic ventricular extrasystoles (VES) during routine ergometry.
  • Resting ECG showed VES, and long-term ECG recorded up to 100 VES per hour.
  • Echocardiography revealed prominent apical trabeculae in the left ventricle and lower right ventricle.
  • Cardio-MRT showed lateral and apical wall dilation with increased trabecularization but no late enhancement.

Findings:

  • Diagnosis of a mild, asymptomatic form of noncompaction cardiomyopathy (NCCM).
  • Treatment includes guideline-based cardiac insufficiency management and ICD-CRT therapy.
  • Ramipril was recommended, and transvenous ICD implantation was deferred due to the unavailability of subcutaneous ICD systems at the time.

Implications:

  • Family screening and genotyping are recommended for affected individuals.
  • The study suggests that asymptomatic or borderline findings of NCCM can exist, even in athletes.
  • Further research is needed to investigate the potential protective influence of sports activities on cardiovascular adaptations in NCCM patients.