Medical Case Study: The Sudden Collapse of a Young Athlete

A 20-year-old male is admitted to the emergency room after suddenly collapsing during a soccer game. The patient is generally healthy, does not take any medications, and has no previous hospitalizations or surgical procedures. He does not have a history of chest pain or shortness of breath until this incident. The patient’s past medical history revealed that his paternal uncle passed away from sudden cardiac death at 25 years old during a football game. 

The patient was immediately seen by a cardiologist who conducted the following tests: 

1. Electrocardiogram (EKG): An EKG is used to measure the instantaneous electrical activity of the heart.

2. Blood test - Troponin levels: A blood test is used to determine the troponin level. The troponin level can indicate whether the patient suffered from a heart attack. 

3. Echocardiogram: This test is used to check how well the chambers and valves of the heart are pumping blood. It also shows if the heart muscle is abnormally thickened. 

The test results are as follows: 

EKG: The EKG showed signs of left ventricular hypertrophy (LVH). LVH is the thickening of the walls of the left ventricle. 

Source: https://www.mayoclinic.org/diseases-conditions/left-ventricular-hypertrophy/symptoms-causes/syc-20374314#:~:text=Left%20ventricular%20hypertrophy%20is%20thickening,heart%20wall%20can%20become%20stiff.  

Blood test: The troponin level result was normal. 

Echocardiogram: The echocardiogram revealed left ventricular hypertrophy (LVH). 

The possible conditions are: 

Myocardial Infarction (Heart Attack): A heart attack occurs when there is a lack of blood flow to a part of the heart muscle. Symptoms of this condition include shortness of breath, chest pain, lightheadedness, and nausea. A physician will check the cardiac troponin level in the blood to determine if an individual had a heart attack. 

Source: https://my.clevelandclinic.org/health/diseases/16818-heart-attack-myocardial-infarction  

Hypertrophic Cardiomyopathy (HCM): HCM is a common genetic condition of the heart muscle. Individuals with HCM experience symptoms such as fainting after exercise, shortness of breath, chest pain during exercise, and heart palpitations.   

Source: https://www.mayoclinic.org/diseases-conditions/hypertrophiccardiomyopathy/diagnosis-treatment/drc-20350204 

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): ARVC is a rare genetic condition that affects the right ventricle. Symptoms of this condition include chest pain, fatigue, dizziness, and swelling in the legs. 

Source: https://www.cedars-sinai.org/health-library/diseases-and-conditions/a/arrhythmogenic-rightventriculardysplasia.html#:~:text=Arrhythmogenic%20right%20ventricular%20cardiomyopathy%20(ARVC,potentially%20life%2Dthreatening%20heart%20rhythms.  

Please comment on which condition you think this patient has. 

Thank you for reading, 

Ilana Saidov