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Unrecognized hypertrophic cardiomyopathy (HCM) is one cause of exercise-related sudden cardiac death in young athletes. For 10 years, investigators prospectively analyzed cardiac screening results for 3500 asymptomatic elite athletes (98% white) in the U.K. Each athlete underwent 12-lead electrocardiography and two-dimensional echocardiography (echo). Athletes with family histories of HCM or suggestive findings on ECG or echo underwent 48-hour Holter monitoring, cardiopulmonary exercise testing, and magnetic resonance imaging.
In 53 athletes (1.5%), echo suggested left ventricular hypertrophy (LVH). Fifty of these athletes had associated left-ventricle dilation and normal systolic function, consistent with physiologic LVH. The remaining thre…