Athlete heart syndrome

Dr Henry Knipe and Dr David Cuevas et al.

Athlete heart syndrome refers to adaptations in both cardiac structure and function seen in people engaged in high-performance and endurance physical exercise.

The prevalence of the condition has increased due to the increased popularity of recreational exercise, approx 3.6/100,000 young athletes die per year1.

Patients are commonly asymptomatic or have rhythm disturbances (e.g. sinus bradycardia), syncope, palpitations, and/or chest pain. They will have a history of regular physical exercise often over an hour per day.

Athletic heart syndrome is due to adaptations in the cardiovascular system in order to be able to meet the physiological demands required during physical exercise. Hypertrophy and dilatation of the ventricles as a response to exercise causes enlargement of the ventricles. A larger stroke volume due to enlargement of the ventricles makes the cardiac function more efficient and demands can be met with a lower heart rate resulting in bradycardia often.

As the condition is usually asymptomatic diagnosis is usually an incidental finding on echocardiography. Echocardiography can also help to differentiate it from other forms of structural heart disease (e.g. hypertrophic cardiomyopathy).

Cardiac MRI is superior to echocardiography with a sensitivity and specificity of 80 and 90% respectively 2. It is also useful to differentiate the normal adaptation of the heart to exercise from pathological conditions and to discard acute myocarditis (seen in 5–22% of athletes’ sudden cardiac attack) 1.

The condition requires no treatment. There is no proven association between athlete heart syndrome and an increased risk of sudden cardiac death.

Share article

Article information

rID: 64208
Synonyms or Alternate Spellings:
  • Athletic heart syndrome
  • Athlete's heart syndrome

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    Case 1
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.