Athlete's Heart

What is athlete’s heart? Athlete’s heart is the name for the changes that happen in your heart when you do strenuous exercise for more than one hour on most days of the week. Most of the time, these changes aren’t excessive. However, in some athletes, the changes can make your heart look similar to how it looks when you have a form of cardiomyopathy. Because cardiomyopathy isn’t harmless, your provider needs to know what makes athlete’s heart different.

What’s the difference between athlete’s heart and hypertrophic cardiomyopathy? Some electrocardiogram results appear similar for these two conditions. It’s important to know the difference because one is dangerous and the other isn’t. Hypertrophic cardiomyopathy Can cause sudden cardiac death in athletes. The amount of space inside of your left ventricle gets smaller. Left ventricle wall is thicker than in people with athlete’s heart. Athlete’s heart Doesn’t cause sudden cardiac death in athletes. The amount of space inside of your left ventricle gets bigger. Left ventricle wall is thick, but not as thick as in people with hypertrophic cardiomyopathy.

Who does athlete’s heart affect? Athlete’s heart affects 2% of athletes. This can happen after two years of strenuous training for five hours or more per week. Athlete’s heart is much more common in athletes who are Black than in people of other races.

How does athlete’s heart affect my body?

Your body needs more oxygen when you exercise. To meet this higher demand, your heart’s left ventricle handles more blood and a higher pressure than normal. Your left ventricle pumps oxygen-rich blood to your aorta, which sends it out to your body.

After meeting your body’s need for more blood and oxygen for a while, your left ventricle starts to get bigger and develop thicker heart muscle.

When you’re not working out, your heart doesn’t have to pump as much blood. It can pump what you need at a lower heart rate. This is why people with athlete’s heart syndrome have a heart rate that’s lower than a non-athlete’s heart rate at rest.

What are the symptoms?

There aren’t any athletic heart syndrome symptoms. You most likely have a different heart issue if you have chest pain or palpitations.

What causes athletic heart syndrome?

Intense endurance training or strength training can be athletic heart syndrome causes in some athletes.

Endurance sports tend to increase the size and wall thickness of an athlete’s left ventricle.

Sports that can lead to athlete’s heart include:

- Rowing.

- Swimming.

- Cross-country skiing.

- Cycling.

How do you know if you have athlete’s heart?

A healthcare provider can diagnose you based on athlete’s heart syndrome signs and symptoms, such as:

- A heart murmur that your provider can hear through their stethoscope.

- Extra heartbeat sounds that aren’t normally there.

- Slow heart rate (bradycardia).

- Lower blood pressure.

What tests will be done to diagnose athlete’s heart?

Tests to diagnose athlete’s heart include:

- Electrocardiogram (EKG). Unusual results happen while at rest but not during exercise in people with athlete’s heart.

- Echocardiogram.

- Chest X-ray.

- Cardiopulmonary exercise testing.

- Heart MRI (rarely used for this).

- Stress test (rarely used for this).

How do you treat athlete’s heart?

You don’t need treatment for athlete’s heart syndrome. However, your healthcare provider may ask you to stop training for three months and reimage your heart to ensure you don’t have cardiomyopathy.

Does athlete’s heart go away?

Yes. In most people, your heart returns to a normal size after you stop training so hard. However, a study found that 20% of former athletes still had a large left ventricle five years later.

How can I reduce my risk?

Because athlete’s heart is the heart’s normal response to intense, aerobic exercise, you don’t need to reduce your risk because it’s not a dangerous condition.