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July 18, 2026JACC Case ReportsOpen Access

CMR reveals multifocal myocardial scarring concerning for cardiomyopathy in an endurance athlete with suspected physiological remodeling.

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Population

37-year-old male endurance athlete with incidentally discovered cardiac enlargement on screening coronary…

Design

Case_report

Key result

Cardiac magnetic resonance imaging revealed multifocal myocardial scarring concerning for cardiomyopathy in a 37-year-old male endurance athlete with suspected physiological remodeling.

Authors

TJTaha JilaniSKShahrukh KhanYFYeva Fakikh

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Overview

Highlights the utility of advanced imaging to differentiate benign athlete’s heart from underlying pathology; extends.

Key Points

  • The aim is to differentiate between physiological cardiac remodeling in athletes and cardiomyopathy.
  • Case study of a 37-year-old male endurance athlete referred after a screening coronary calcium scan.
  • Assessment included electrocardiography, echocardiography, and cardiac magnetic resonance imaging.
  • Individualized management decisions were made based on advanced imaging results.
  • Advanced imaging revealed multifocal myocardial scarring concerning for cardiomyopathy.
  • Patient resumed exercise after guideline-directed medical therapy and shared decision-making.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
A 37-year-old male endurance athlete with incidental cardiac enlargement evaluated for athlete's heart versus cardiomyopathy.
E
Exposure
Advanced cardiac imaging (cardiac magnetic resonance imaging) and guideline-directed medical therapy
O
Outcome
Differentiation of physiological remodeling from cardiomyopathy

Multimodality imaging, specifically cardiac MRI, can provide crucial diagnostic insights to differentiate physiological athlete's heart from cardiomyopathy when standard evaluation is uncertain.

Cite This Study

Jilani et al. (2026) conducted a case report in Athlete's heart vs Cardiomyopathy (n=1). Advanced cardiac imaging (cardiac magnetic resonance imaging) was evaluated on Diagnosis of cardiomyopathy. Cardiac magnetic resonance imaging revealed multifocal myocardial scarring concerning for cardiomyopathy in a 37-year-old male endurance athlete with suspected physiological remodeling.

synapsesocial.com/papers/6a5b38f68167787360d24df3https://doi.org/10.1016/j.jaccas.2026.109231
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