Ventricular hypertrophy in a young weightlifter

An adult patient presented with palpitations, chest pain and reduced exertional capacity for 3 years. Previously, the patient was an amateur weightlifter who used anabolic steroids but had ceased supplements 3 years before admission. There was no family history of cardiovascular disease or sudden cardiac death. Blood pressure was elevated. The 12-lead ECG showed left ventricular hypertrophy and T wave inversion in the lateral and precordial leads. Laboratory tests revealed an elevated N-terminal pro-brain natriuretic peptide (NT-proBNP), normal high-sensitivity troponin T and severe hypertriglyceridaemia. Transthoracic echocardiography is shown in figure 1. Genetic analysis excluded sarcomere protein gene mutations as well as other genetic causes of cardiomyopathy including metabolic diseases and neuromuscular disorders. The patient underwent a treadmill ECG stress test and there was no evidence of inducible ischaemia. Figure 1(A) Two-dimensional transthoracic echocardiography; (B) speckle-tracking echocardiography and bull’s eye representation: Global longitudinal strain (GLS)=–7.4%, reduced...
Source: Heart - Category: Cardiology Authors: Tags: Image challenges Source Type: research