Aortic Regurgitation and Progressive Left Ventricular Dilation in a Professional Hockey Player.

BACKGROUND

Distinguishing physiologic left ventricular (LV) remodeling from pathological LV dilation is a challenge among athletes with aortic regurgitation (AR).

CASE SUMMARY: A 30-year-old professional hockey player with longstanding moderate AR and progressive LV dilation was restricted from sport, and surgical valve replacement was recommended. A detailed exercise training history revealed a marked increase in endurance training during recent months. Transthoracic echocardiography confirmed moderate AR and LV dilation with normal systolic and diastolic function. Cardiopulmonary exercise testing demonstrated a VO2 max of 47 mL/kg/min (135% predicted) with reduction in AR severity during exercise. Surgery was deferred, and a return-to-play strategy with longitudinal surveillance was developed.

DISCUSSION: Although regurgitant valvular disease is typically well tolerated in competitive athletes, the literature on this topic is sparse.

TAKE-HOME MESSAGE: A detailed exercise training history is essential in the clinical interpretation of imaging data among athletes with regurgitant valve lesions and abnormal chamber dimensions.