Sudden death in mild hypertrophic cardiomyopathy with compound DSG2/DSC2/MYH6 mutations: Revisiting phenotype after genetic assessment in a master runner athlete

J Electrocardiol. 2019 Mar-Apr:53:95-99. doi: 10.1016/j.jelectrocard.2019.01.002. Epub 2019 Jan 2.

Abstract

Cardiomyopathies represent a well-known cause of heart failure and sudden death. Although cardiomyopathies are generally categorized in distinct nosographic entities, characterized by single gene-to-disease causal relationships, recently, oligogenic mutations have also been associated to relevant cardiac clinical features. We report the case of a master athlete carrying trigenic mutations in desmoglein-2 (DSG2), desmocollin-2 (DSC2) and heavy chain myosin 6 (MYH6), which determine a mild hypertrophic phenotype associated both to ventricular tachyarrhythmias and atrio-ventricular block. We discuss the differential diagnosis and prognostic approach in patient affected by complex cardiomyopathy phenotype, along with the importance of sport restriction and sudden death prevention.

Keywords: Complex cardiomyopathy phenotype; Next Generation Sequencing; Sudden cardiac death.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Athletes*
  • Atrioventricular Block / complications
  • Atrioventricular Block / genetics
  • Cardiac Myosins / genetics
  • Cardiomyopathy, Hypertrophic / complications
  • Cardiomyopathy, Hypertrophic / genetics*
  • Death, Sudden, Cardiac / etiology*
  • Desmocollins / genetics
  • Desmoglein 2 / genetics
  • Diagnosis, Differential
  • Electrocardiography
  • Humans
  • Middle Aged
  • Mutation
  • Myosin Heavy Chains / genetics
  • Pacemaker, Artificial
  • Phenotype
  • Prognosis
  • Tachycardia, Ventricular / complications
  • Tachycardia, Ventricular / genetics

Substances

  • DSC2 protein, human
  • Desmocollins
  • Desmoglein 2
  • MYH6 protein, human
  • Cardiac Myosins
  • Myosin Heavy Chains