Document Type

Report

Publication Date

7-15-2026

Comments

This article is the author’s final published version in JACC: Case Reports, Volume 31, Issue 28, 2026, Article number 108864.

The published version is available at https://doi.org/10.1016/j.jaccas.2026.108864. Copyright © 2026 Published by Elsevier on behalf of the American College of Cardiology Foundation.

 

Abstract

BACKGROUND: Return-to-play (RTP) decisions for professional athletes with arrhythmias are challenging, particularly when the diagnosis is uncertain.

CASE SUMMARY: A 33-year-old professional football player presented for RTP evaluation of premature ventricular contractions (PVCs) and atypical chest pain. Work-up was significant for fragmented R waves and PVCs on electrocardiogram as well as late gadolinium enhancement on cardiac magnetic resonance imaging. Positron emission tomography scan was normal. These findings suggested possible subacute myocarditis. He elected to rest for 2 to 3 months and was treated with guideline-directed medical therapy. Risk stratification highlighted increased risks associated with late gadolinium enhancement and incomplete genetic evaluation, though PVC morphology and normal positron emission tomography scan supported a favorable risk profile.

DISCUSSION: This case underscores the complexity of RTP decisions in athletes with arrhythmias of uncertain etiology, emphasizing individualized evaluation.

TAKE-HOME MESSAGE: Real-world RTP decisions often do not align with diagnostic pathways; clinicians must integrate clinical data, athlete goals, and evolving evidence.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

42460971

Language

English

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