CASE REPORT   

Medicina dello Sport 2019 June;72(2):305-11

DOI: 10.23736/S0025-7826.19.03460-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

A rare case of right-located aortic arch and Kommerell diverticulum in a young athlete

Tommaso BALLATORE ✉, Claudio DANIELI, Mario D. SIRTORI

Unit of Hygiene and Public Health MI Est, Sports Medicine, Department of Prevention, ATS Milan, Pioltello, Milan, Italy

The article describes a case of a young soccer player (14 years old), asymptomatic, with positive Wolff-Parkinson-White Syndrome paternal familiarity, who, at medical examination for competitive sports suitability, showed a marked sinus bradycardia (39 bpm) and high voltage signals in left ventricular derivations. After being subjected to second-level instrumental tests (Holter electrocardiography, cycle ergometer stress test and echocardiography), an increase in the thickness of the interventricular septum (13 mm) was noticed, which suggested performing a cardiac magnetic resonance imaging. The investigation revealed a modest left ventricular dilatation and a prolapse of the anterior mitral valve flap, a slight aortic insufficiency, the presence of a right-sided aortic arch and a Kommerell diverticulum positioned at the origin of the left subclavian artery. Scientific literature does not provide reliable data on the possible complications of the current vascular pathology, therefore sport eligibility has been denied. The aim of this work was to contribute to the casuistry of aortic arch anomalies with the concomitant presence of Kommerell diverticulum, to highlight the particularity of its association with sporting activity and to underline the practical implications that derive from it.

KEY WORDS: Diverticulum; Bradycardia; Athletes