Dead Lifts and Death: Sudden Death due to Hypertrophic Cardiomyopathy in a Body Builder

BACKGROUND: It is a well established fact that cardiac health and exercise go hand in hand. However, rigorous exercising regimens without proper cardiovascular screening can lead to catastrophic death in unsuspecting and otherwise healthy individuals. Among the underlying undetected cardiovascular conditions that need to be accounted for, especially in young adults, are hypertrophic cardiomyopathies. CASE DETAILS: The deceased, a 33-year-old state level bodybuilder, was participating in a body building competition when he suddenly complained of dizziness and collapsed. The deceased appeared to have no significant findings on external examination. Internal examination, however, revealed that the heart was enlarged and weighed 698 g. On microscopic examination, ventricle sections showed enlarged myocytes with disarray and enlarged nuclei. The cause of death was ascertained to be due to complications of hypertrophic cardiomyopathy. IMPLICATIONS FOR CLINICAL, PRACTICE: Among the feasible options available in low and middle income countries, electrocardiography is an inexpensive method as a screening test, leading the way for using tools such as CMR, serum biomarkers and genetic testing if required. CONCLUSION: Understanding the relationship between physical exertion and its effect on a hypertrophic heart is essential. The case presented brings to light the need for in-depth precompetition screening of athletes. This is especially true since athletes are the one category of individuals where good health is taken for granted.