📌 TL;DR: Caso de HCM apical persistente durante 25 años con seguimiento médico adecuado.
🔬 Puntos clave:
- Evolución prolongada del HCM apical en atleta profesional.
- Mantenimiento de capacidad funcional y ausencia de síntomas a largo plazo.
- Reducción de paro ventricular tras cambio de club.
- Formación de aneurisma apical antes de retiro.
🎯 Aplicación clínica para LATAM:
Este caso es relevante para la práctica deportiva en Panamá, donde se deben considerar cuidadosamente los criterios de seguimiento y decisiones terapéuticas en atletas con HCM. El estudio subraya la importancia del seguimiento personalizado en estos casos.
⚠ Limitaciones:
El caso es único y limitado por su longitud de seguimiento, lo que puede no ser generalizable a todos los pacientes con HCM apical.
Background
Hypertrophic cardiomyopathy (HCM) is a leading cause of sudden cardiac death in young athletes. Risk stratification and disease evolution in athletes who continue competitive sport, particularly in apical phenotypes, remain incompletely defined.
Case summary
A 14-year-old academy football player was diagnosed with subclinical HCM during preparticipation screening and elected to continue competing despite contemporaneous guideline restrictions. Over 25 years of follow-up, he progressed to apical HCM with late gadolinium enhancement and mild ventricular ectopy but maintained excellent functional capacity and remained asymptomatic. After transferring to a lower-tier club, both palpitations and ventricular ectopy decreased. He completed a long professional career and developed an apical aneurysm shortly before retiring.
Discussion
This case highlights the complexity of exercise counseling in HCM and is consistent with contemporary guideline-supported, individualized decision-making, as it illustrates that selected low-risk athletes may tolerate long-term competition. The extended follow-up highlights the long-term natural history of apical HCM in an athlete and underscores persistent uncertainties regarding phenotype-specific risk modifiers, including myocardial fibrosis and apical aneurysm formation.
Take-home message
Personalized, shared decision-making is essential in athletes with HCM, and refined risk-stratification models are urgently needed.
Cómo citar:
Papatheodorou E, Vlagkouli V, Anastasakis A. (2026).
25-Year Evolution of Apical Hypertrophic Cardiomyopathy in a Professional Athlete.. JACC. Case reports.
DOI: 10.1016/j.jaccas.2026.107495 ↗ PMID: 41906580 ↗ Acceso al paper: Ver completo ↗
