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A 52-year-old man lost consciousness while running on a hot day. He had been a professional football player for 15 years. ECG showed sinus rhythm, high R voltages with T inversion fulfilling the criteria for left ventricular (LV) hypertrophy (Figure 1A). This ECG LV hypertrophy pattern had been discovered at the age of 15 interpreted as ‘athlete's heart’. An echocardiographic exam showed normal ventricular volumes, wall thickness and contractility, but a defect in the apical interventricular septum was present (Figure 1B; online supplementary video S1). A cardiac …
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