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Medicina dello Sport 2021 March;74(1):146-52

DOI: 10.23736/S0025-7826.21.03844-8


language: English, Italian

Hypoplasia of pulmonary artery’s left branch and thoracic-abdominal aorta in a young athlete with Perthes disease

Tommaso BALLATORE 1, 2 , Mario D. SIRTORI 1, 2, Claudio DANIELI 1, 2

1 Unit of Sports Medicine, ATS Milano Città Metropolitana, Pioltello, Milan, Italy; 2 Unit of Hygiene and Public Health, Department of Prevention, Pioltello, Milan, Italy


The article describes the case of a young athlete, aged 11, asymptomatic, who, at the medical examination for competitive sports fitness, for the practice of swimming, presented, at the basal ecg, a reduced progression of the R wave, the absence of transition, and increase in R-wave voltages in the precordial leads. The negative cardiological history due to familiarity showed, however, a previous echocardiographic finding, at the age of 4, of a mild and negligible distal stenosis of the pulmonary arteries, of little importance. At the age of 8, she underwent a variating osteotomy to center the left femur, in order to correct hip and pelvis osteochondrosis (Perthes disease). A 2nd level cardiological screening was begun, including an echocardiogram and a cycloergometer-based exercise test. While, on one hand, the latter was negative for functional exercise capacity, the first revealed instead an accentuation of the echocardiographic anomaly of the pulmonary and aortic hemodynamic parameters already reported in the medical history. Sent to perform CINE MRI with contrast medium, the diagnosis was made of hypoplasia of the left branch of the pulmonary artery, thoracic and abdominal aorta in the area surrounding the renal arteries. As a result, she was reported unsuitable for competitive swimming and was referred to a specialist surgical visit. The aim of this work is to contribute to the case history of large vessel hypoplasia in pediatric age and to highlight a rare association between aortic and pulmonary artery anomalies in an individual affected by Perthes disease, thus stimulating reflection in sports medicine to understand the relationships between these pathologies and sports activity.

KEY WORDS: Aorta; Legg-Calve-Perthes disease; Case report

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