Hypertrophic cardiomyopathy--sports-related aspects of diagnosis, therapy, and sports eligibility.

Hypertrophic cardiomyopathy (HCM) is one of the primary causes of sudden cardiac death in athletes < 35 years of age. The highest risk of sudden cardiac death is associated with syncope, early age, extreme ventricular hypertrophy, ventricular tachycardia, and a family history of sudden death. The relative risk in competitive sports is unknown. Usually, sports eligibility is rejected. However, some athletes with HCM tolerate extreme athletic lifestyles without complications. Sports-related aspects of diagnosis, therapy, and sports eligibility are presented, and discussed. Two case reports are presented: a 20-year-old professional soccer player and a 66-year-old long-distance runner. Athletes with HCM should not participate in most competitive sports with the possible exception of those of low dynamic and low static intensity. Participation in low to moderate athletic activities may be allowed in selected patients without risk factors and > 35 years of age.