II. Physiology

  1. Regular intensive Exercise results in normal reversible heart adaptations with cardiac remodeling

III. Signs

  1. Increased Left Ventricular wall thickness by 15-20%
  2. Increased Left Ventricular End Diastolic Volume by 10%
  3. Resting Heart Rate: 40-60 bpm
  4. Irregular pulse
  5. Increased Pulse Pressure
  6. S3 Gallup at Apex (S4 Gallup should raise red flag)
  7. Physiologic split S2

IV. Imaging

  1. Chest XRay
    1. May show globular cardiomegaly
    2. Increased pulmonary vasculature
  2. Echocardiogram: Left Ventricular Dilatation (dynamic)
    1. Left Ventricular wall thickening (static)
    2. Normal Systolic and Diastolic function

V. Diagnostics: Electrocardiogram

  1. Electrocardiogram changes resolve when exercising
  2. Sinus Bradycardia with or without Arrhythmia
  3. Increased False Positive stress tests
  4. Atrioventricular conduction delays
    1. First degree block
      1. Athletes: 10-33% Incidence
      2. General population: 0.65% Incidence
    2. Mobitz I
      1. Athletes: 10% Incidence
      2. General population: 0.003% Incidence
    3. Mobitz II
      1. Athletes: 8% Incidence
  5. Increased QRS Complex height
    1. Left Ventricular Hypertrophy criteria
    2. Right Ventricular Hypertrophy criteria
  6. Wide QRS Complex (incomplete Right Bundle Branch Block)
    1. Athletes: 14% Incidence
    2. General athletes: 10% Incidence
  7. Repolarization changes
    1. ST Segment Elevation
    2. Flipped T Waves

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Related Studies

Ontology: Athlete's heart (C0340520)

Concepts Disease or Syndrome (T047)
SnomedCT 233931008
Italian Sindrome del cuore dell'atleta
Japanese スポーツ心臓症候群, スポーツシンゾウショウコウグン
English athlete's heart (diagnosis), athlete's heart, athletic heart syndrome, Athlete's heart, Athletic heart syndrome, Athlete's heart (disorder)
Czech Sydrom atletického srdce
Hungarian Sportoló-szív syndroma
Spanish corazón de atleta (trastorno), corazón de atleta, síndrome de corazón de atleta, Síndrome del corazón de atleta
Dutch athletic heart syndrome
French Syndrome du coeur d'athlète
Portuguese Síndrome do coração de atleta
German Sportlerherz