Dear All

I have a patient, african-american professional sportsman.

Asymptomatic, in a pre-participation screening, ECG was abnormal, with minor inverted T-waves in V4-V6 leads. There are neither familiar history of cardiovascular diseases nor sudden deaths. There are no previous medical data about this patient.

It raised the suspicion of an hypertrophic cardiomyopathy (HCM), but the echocardiogram did not show any disturbance (left ventricular wall of 11 mm).

Obviously, inverted T waves in lateral leads should warrant a follow-up: education with regard to the development of symptoms and yearly cardiac evaluation.

Current guidelines suggest in this case “unrestricted participation to competitive sports but offer genetic testing” (see attached file, p. i56)

Given the role of epigenetics, the sport as professional activity and the possibility of an inconclusive result, is the genetic assessment really of interest in this case?