Case report of a 16-year-old with PRKAG2-associated hypertrophic cardiomyopathy whose condition progressed to arrhythmias and ventricular scarring, with sports participation and potential ICD placement managed via shared decision-making.

Negligible relevance to Parkinson's therapeutic discovery because it is a cardiology case focused on adolescent HCM and shared decision-making with no mechanistic, biomarker, or therapeutic links to Parkinson's disease.

BACKGROUND: Providers treating pediatric athletes with hypertrophic cardiomyopathy (HCM) face challenging decisions for competitive sports participation. CASE SUMMARY: A 16-year-old with PRKAG2+ HCM with Wolff-Parkinson-White presented for a second opinion regarding baseball participation. Under previous care, he was allowed to play baseball in a limited capacity. He had no symptoms or arrhythmias, and cardiac magnetic resonance imaging demonstrated asymmetric septal wall thickening without fibrosis and was initially cleared for full baseball participation. Over time, new arrhythmias were noted, and ventricular scar was seen on cardiac magnetic resonance. Using shared decision-making (SDM), the patient now plays competitive golf and is considering an implantable cardioverter defibrillator. DISCUSSION: This case demonstrates the temporal evolution of HCM and the importance of SDM when considering sport participation. Sports can play an important role in quality of life, and this should be considered in SDM. TAKE-HOME MESSAGE: HCM can evolve through adolescence, and SDM can assist in sport-participation decisions.