Apical Hypertrophic Cardiomyopathy and Elite-Level Sports: A 12-Year Follow-Up Case

Background: Apical hypertrophic cardiomyopathy (aHCM) is a distinct, rarer phenotype with a potentially more favorable prognosis and lower morbidity than nonapical forms of hypertrophic cardiomyopathy, yet its specific interaction with elite-level sports remains poorly defined. Case Summary: This case describes an asymptomatic athlete found to have aHCM, for whom engaging in elite sports from ages 17 to 31 years did not lead to adverse morphologic changes or progression of apical fibrosis or disease, even after the cessation of his professional sports career. Discussion: This case underscores the importance of recognizing aHCM as a distinct subtype of hypertrophic cardiomyopathy, potentially exhibiting a more benign interaction with sports. Furthermore, it highlights the value of a multidisciplinary expert panel in providing sports guidance to elite athletes with cardiovascular conditions. Take-Home Messages: Distinguish aHCM as a subtype that may carry a lower risk profile in elite athletes. Multidisciplinary shared decision-making is essential for individualized sports eligibility.