Unusual Cause of a Cardiac Arrest in a Former African American Collegiate Athlete.

Yamaguchi-variant cardiomyopathy is an underreported but significant cause of cardiac arrest among athletes. We studied the hospital course of one patient who arrived at the emergency department after a sudden cardiac arrest while playing a recreational basketball game. We used the electronic medical record (Epic) to follow the notes, labs, imaging, and procedures that were performed. Although a rare disease, Yamaguchi syndrome should not be overlooked when working up a patient who has suffered a sudden cardiac arrest. Proper knowledge of automatic external defibrillators and basic cardiopulmonary resuscitation principles can have a significant positive impact, and the importance of these interventions should not be overlooked in patients with a sudden cardiac arrest.

No Pain and No Gain: Kommerell's Diverticulum with a Right-Sided Aortic Arch, and an Aberrant Left Subclavian Artery Presenting in a Body Builder with Muscle Bulk Imbalance.

A 22-year-old right-handed male presented to the Sports Medicine clinic with concerns of upper extremity muscle asymmetry. Physical examination showed gross muscular asymmetry when comparing the left upper extremity to the right. Radial pulses were 2 + on the right and 1 + on the left. Due to concern for vascular anomaly, computed tomography angiography was performed which revealed a right-sided aortic arch with Kommerell's diverticulum and aberrant left subclavian artery. The patient underwent a left carotid subclavian bypass successfully, but his recovery was complicated by an upper extremity deep venous thrombosis. He is currently on novel anticoagulant but has been released to normal activities and doing well. Kommerell's Diverticulum (KD) is a rare congenital anomaly caused by a persistent remnant of the fourth primitive dorsal arch during embryological development. Although the prevalence of KD is rare, it is important to identify and diagnose this condition to provide definitive care.

The effect of landing surface on landing error scoring system grades.

Different landing surfaces may affect lower extremity biomechanical performance during athletic tasks. The magnitude of this effect on clinical screening measures such as jump-landings is unknown. This study determined the effect of court (CS), grass (GS), and tile (TS) surfaces on Landing Error Scoring System (LESS) grades. A repeated-measures design was used. A total of 40 (21F, 19M; mean age = 23.8 ± 2.4 yr) recreational athletes performed a jump-landing task on three different landing surfaces. 2D videography recorded jump-landings in the frontal and sagittal planes. A 2 × 3 (sex by surface) mixed-model repeated-measures analysis of variance was used to examine main and interaction effects associated with surface and sex. No significant sex by landing surface interactions existed for LESS grades. No significant differences were observed on LESS grades for the main effect of surface (CS = 4.83 ± 1.31 points; GS = 5.01 ± 1.40 points; TS = 5.09 ± 1.86 points; all p > 0.05). Correlations were found between LESS grades among different conditions (r range = 0.587-0.611; all p < 0.001). Commonly used jump-landing surfaces for clinical biomechanical evaluations do not affect LESS grades, suggesting generalisability as a screening tool for anterior cruciate ligament injury risk in different sport environments.

High Prevalence of Pericardial Involvement in College Student Athletes Recovering From COVID-19.

OBJECTIVES: This study sought to explore the spectrum of cardiac abnormalities in student athletes who returned to university campus in July 2020 with uncomplicated coronavirus disease 2019 (COVID-19). BACKGROUND: There is limited information on cardiovascular involvement in young individuals with mild or asymptomatic COVID-19. METHODS: Screening echocardiograms were performed in 54 consecutive student athletes (mean age 19 years; 85% male) who had positive results of reverse transcription polymerase chain reaction nasal swab testing of the upper respiratory tract or immunoglobulin G antibodies against severe acute respiratory syndrome coronavirus type 2. Sequential cardiac magnetic resonance imaging was performed in 48 (89%) subjects. RESULTS: A total of 16 (30%) athletes were asymptomatic, whereas 36 (66%) and 2 (4%) athletes reported mild and moderate COVID-19 related symptoms, respectively. For the 48 athletes completing both imaging studies, abnormal findings were identified in 27 (56.3%) individuals. This included 19 (39.5%) athletes with pericardial late enhancements with associated pericardial effusion. Of the individuals with pericardial enhancements, 6 (12.5%) had reduced global longitudinal strain and/or an increased native T1. One patient showed myocardial enhancement, and reduced left ventricular ejection fraction or reduced global longitudinal strain with or without increased native T1 values was also identified in an additional 7 (14.6%) individuals. Native T2 findings were normal in all subjects, and no specific imaging features of myocardial inflammation were identified. Hierarchical clustering of left ventricular regional strain identified 3 unique myopericardial phenotypes that showed significant association with the cardiac magnetic resonance findings (p = 0.03). CONCLUSIONS: More than 1 in 3 previously healthy college athletes recovering from COVID-19 infection showed imaging features of a resolving pericardial inflammation. Although subtle changes in myocardial structure and function were identified, no athlete showed specific imaging features to suggest an ongoing myocarditis. Further studies are needed to understand the clinical implications and long-term evolution of these abnormalities in uncomplicated COVID-19.

Previous High School Participation in Varsity Sport and Jump-Landing Biomechanics in Adult Recreational Athletes.

CONTEXT: Early sports sampling is associated with superior biomechanics in youth athletes; however, the effect of multisport participation on adult biomechanics is unknown. OBJECTIVE: To compare jump-landing biomechanics between adult recreational athletes who previously participated in 0, 1, or 2 or more select high school varsity sports (VSs; basketball, lacrosse, soccer, volleyball) that feature landing and cutting tasks. DESIGN: Descriptive laboratory study. SETTING: University community setting. PATIENTS OR OTHER PARTICIPANTS: Fifty adult recreational athletes (22 women, 28 men; age = 23.8 ± 2.5 years) with no high school VS experience or with high school VS experience in basketball, lacrosse, soccer, or volleyball. Athletes were grouped into those who participated in 0 (0VS, n = 11), 1 (1VS, n = 21), or 2 or more (2VSs, n = 18) of these sports at the high school level. MAIN OUTCOME MEASURE(S): The average Landing Error Scoring System (LESS) total score from 3 individual jump landings was determined. A 1-way analysis of covariance using sex as the covariate was calculated to compare groups. The Pearson R was used to test for the correlation between the LESS score and number of sports played, and a linear regression analysis was performed using the number of sports played to predict the LESS score. The α level was set a priori at .05. RESULTS: The 0VS athletes produced similar LESS scores as the 1VS athletes (5.89 ± 1.2 versus 5.38 ± 1.93 points, respectively, P = .463), whereas the 2VSs athletes demonstrated lower LESS scores (3.56 ± 1.97 points) than the 0VS (P = .002) and 1VS (P = .004) athletes. The LESS scores were moderately negatively correlated with the number of high school VSs played (R2 = -0.491, P < .001). The linear regression analysis was significant (F1,37 = 9.416, P = .004) with R2 = 0.203. For every additional VS played at the high school level, the LESS score decreased by 1.28 points. CONCLUSIONS: Landing Error Scoring System scores were lower in athletes who had a history of multisport high school varsity participation in basketball, lacrosse, soccer, or volleyball compared with those who had a history of single-sport or no participation in these sports at this level. Multisport high school varsity participation in these sports may result in improved neuromuscular performance and potentially reduced injury risks as adults.