Hypertrophic cardiomyopathy in an athlete, occurring under the mask of sports remodeling. Secondary prevention of sudden cardiac death. Analysis of a clinical case

Abstract

HCMP is a severe heart disease characterized by high rates of sudden mortality, especially in young people. Optimization of the tactics of treatment of children with HCMP in order to improve the prognosis remains one of the urgent tasks of cardiology. A clinical case of a 15-yearold boy with moderate myocardial hypertrophy and an asymptomatic course of HCMP is presented, in connection with which the disease was not diagnosed for a long time. The boy was engaged in professional sports, during the competition he suddenly lost consciousness, clinical death occurred. Only timely resuscitation measures allowed to save the patient’s life. Implantation of a cardioverter defibrillator was performed as a secondary prevention of SCD (class 1 indications). The importance of timely examination of asymptomatic athletes with myocardial hypertrophy for differential diagnosis between HCMP and myocardial remodeling against the background of intense physical exertion (“athlete’s heart”) is emphasized. The importance of solving the issue of the inadmissibility of intense physical exertion, even with an asymptomatic course of HCMP, is shown. It should be remembered that it has been established that intense sports loads act as a trigger for cardiac arrest in patients with HCMP. Retrospective calculation of SCD risk based on HCM risc-SDD calculator/The BCC risk calculator at GCMP showed 3.19 %, which corresponded to a low risk. The possibility of SCD in patients with HCMP is emphasized, even with an estimated low risk, which requires further research to find predictors of an unfavorable outcome.