Aortopathy and Bicuspid Aortic Valve in a College Football Player

A 20-year-old collegiate American-style football player presents to our sports cardiology clinic after referral from a mobile athletic screening program that included 12-lead electrocardiography and complete 2-D transthoracic echocardiography. He is asymptomatic, has no significant medical history, no significant known family history and takes no medications or supplements. On physical exam, he is 6' tall, weighs 88 kgs, has a blood pressure of 113/72 and has a normal cardiovascular exam with no murmurs or ejection sounds appreciated. He plays as a defensive back, a non-lineman position. His ECG (Figure 1) and selected views from his cardiac imaging studies (Figure 2A and 2B) are shown below. He was found to have a native bicuspid aortic valve and an aortic root with maximum diameter of 42mm by 43 mm as measured by cardiac MRI. There was no aortic stenosis or regurgitation present.

Figure 1: Normal 12-lead electrocardiogram

Figure 1

Figure 2A: CMR With Bicuspid Aortic Valve and No Aortic Stenosis or Regurgitation

Figure 2

Figure 2B: CMR With Maximum Diameter of the Aortic Root (Coronary Sinus) of 42x43mm

Figure 3

According to the 2015 Eligibility and Disqualification Recommendations for Competitive Athletes with Cardiovascular Abnormalities, which of the following is recommended for this condition and specific patient?

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