Clinical and Cardiovascular Magnetic Resonance Findings in Endurance Athletes With Symptomatic Stroke.
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All Authors
Chambers, BS.
Javed, W.
Fyyaz, S.
Mercer, B.
Soo, CY.
Papadakis, M.
Sharma, S.
Swoboda, PP.
LTHT Author
Mercer, Ben
LTHT Department
Cardio-Respiratory
Cardiology
Cardiology
Non Medic
Publication Date
2026
Item Type
Case Reports
Journal Article
Language
Subject
ATRIAL FIBRILLATION , CARDIOVASCULAR SYSTEM , MAGNETIC RESONANCE IMAGING , EXERCISE , HYPERTENSION , STROKE
Subject Headings
Abstract
BACKGROUND: Stroke in athletes is believed to be rare given fewer traditional stroke risk factors in this population, although there is a distinct lack of data. We present a case series of 6 veteran endurance athletes who experienced symptomatic strokes and underwent cardiovascular magnetic resonance imaging.
CASE SUMMARY: Underlying causes of the stroke were established in 5 athletes: atrial fibrillation (n = 2), likely apical hypertrophic cardiomyopathy with thrombus, patent foramen ovale, and carotid artery dissection. Nonischemic myocardial fibrosis was highly prevalent, while exercise-induced hypertension was present in approximately half of the cases.
DISCUSSION: Our findings illustrate a range of etiologies causing stroke in athletes. They also highlight weaknesses with stroke risk-stratification methods in athletes with atrial fibrillation, along with possible modifiable risk factors including masked hypertension and exercise-induced hypertension. Our cases highlight the role of cardiovascular magnetic resonance in detecting the etiology of stroke and propose myocardial fibrosis as a potential novel marker of stroke risk in veteran endurance athletes.
Journal
JACC. Case Reports