What is Athlete’s heart?

Athlete’s heart is a benign condition consisting of adaptation related to work done by the heart as a response to exercise. The primary features are hypertrophy of the walls of the heart with slowed heart rate (Bradycardia) with normal systolic and diastolic function of the heart. The changes are almost universally present in highly trained athletes.

What is the relevance of exercise with Athlete’s Heart?

The changes seen in the Athlete’s heart overlap with those seen in the pathological condition of the heart and need to be ruled out to avoid catastrophic consequences of sport or physical activity participation. Different exercises (endurance or strength training or combined exercises) have different effects on the walls of the heart.

What do you see on Clinical examination?

Athlete’s heart is usually asymptomatic. However, any history of exercise-related chest pain, syncope, dizziness, and collapse should raise the suspicion of a pathology. This should further prompt to know about the risk factors for heart disease. American heart association recommends a 14 point evaluation for cardiovascular screening for athletes. The details of this screening questionnaire can be seen by clicking on the following link:

The current guidelines suggest to do ECG along with the 14 point evaluation.

Read the Australasian College of Sport and Exercise Physicians (ACSEP) Position Statement on Pre- Participation Cardiac Evaluation in Young Athletes below:

How are ECG and other investigations interpreted?

This is a vast subject with multiple scenarios. If you are interested, then we recommend you to read the topic in detail by clicking on the following link on the ‘International Criteria for Electrocardiographic Interpretation in Athletes: Consensus statement’.

Further investigations are required only if there is a suspicion of underlying heart condition or the athlete presents with symptoms which warrant ruling out the heart pathology.

What ongoing care is needed?

Generally, exercise-induced changes in heart get reversed on stopping the exercise. In case of overlapping changes or suspicion of an underlying heart condition, the athlete should be assessed by the cardiologist and investigated further as needed before clearance to play. If an athlete has a serious heart pathology then further sports participation should be discussed in detail, weighting all the risks and benefits.
Any musculoskeletal injury related to sport, work, traffic accident etc.

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