Well trained athletes may have a heart that looks very different, often mimicking a diseased state.
A deeper dive and few sophisticated tests can help differentiate between a healthy athletic heart and diseased heart.
What are some common changes one can see?
1- Enlargement of various chambers of the heart
2- Thicker walls
3- Enlarged and sometimes weak right side of the heart, especially in athletes with serious endurance training.
4- Generally slow heart beat at rest and multiple other ecg abnormalities.
Did you know pure endurance training makes your heart look very different than if you did mainly resistance training?
Repeated stress and strain makes the heart adapt by changes to its structure and function. While mostly it is protective adaptation, in rare occasions it could be maladaptive. In most cases the heart returns to its usual state once the athlete stops training.
Controversial topics- It is debatable if increased intensity of exercise beyond a certain point can be actually harmful.
Regular screening of young athletes for heart diseases with ecg, echo is also highly controversial, however a history and physical examination is very reasonable. If athletes are experiencing symptoms they should seek medical attention immediately. The symptoms include- palpitations/fast heart beat, fainting or lightheadedness, chest pain or shortness of breath. If there is family history of sudden death or cardiomyopathy, athletes should be screened prior to starting intense exercise.