[Gallop in the Routineergometrie: Only Chore or Diagnostic Challenge?]

A 47-year-old recreational sportsman showed in a routine ergometry polymorphic ventricular extrasystoles with good physical performance.

In resting ECG impressed ventricular extrasystoles (VES) predominantly right-hand-block-like with superior axis, a long-term ECG yielded up to 100 VES per hour. Echocardiographically imposing 4 - 5 trabeculae, feathered, reticular structures apically in the left and lower in the right ventricle. The cardio-MRT revealed a wall dilation laterally and apically with increased trabecularization, no late enhancement.

mild form of NCCM, currently asymptomatic THERAPY:  Cardiac insufficiency treatment is based on the guidelines, including ICD-CRT therapy. We recommended ramipril and decided against transvenous ICD implantation. At the time of the presentation, subcutaneous ICD systems were not available. Family screening and genotyping of affected persons are recommended.

Most patients have cardiac insufficiency, rhythmic symptoms, or thrombi formation in the noncompact portions of the left ventricular wall. Ventricular tachycardias are frequent and sudden cardiac death is the leading cause of death. Arrythmias are accessible to medication or ablation treatment. Endurance sports lead to favorable adaptations of the cardiovascular system in spite of increased risk of sudden cardiac death. The example shows that asymptomatic boundary findings also exist. Whether a sporting activity has a protective influence must be further investigated.