Athletic Heart Syndrome



Athletic Heart Syndrome


Evan D. Perez, MD

Daniel Murphy, MD, FAAFP

Justin M. Wright, MD, CAQSM



BASICS


DESCRIPTION



  • A benign condition consisting of physiologic adaptations to increased cardiac workload. Primary features include biventricular hypertrophy and bradycardia.


  • Associated with normal systolic and diastolic function


  • Characteristics may overlap with pathologic conditions.


  • Synonym(s): athlete’s heart; physiologic cardiac hypertrophy; exercise-induced cardiac remodeling; exercise-related cardiac remodeling


EPIDEMIOLOGY



  • These adaptations are common in highly trained athletes.


  • Cardiac remodeling has been observed in moderately active adults who exercise 3 to 5 hr per week (1).


  • Mistaken for pathologic conditions


ETIOLOGY AND PATHOPHYSIOLOGY



  • Changes in cardiac structure vary based on type of exercise (2).


  • Cardiac dimensions rarely exceed upper limits of normal.


  • Dynamic exercise (e.g., distance running) (2):



    • Increased heart rate, augmented stroke volume, and decreased systemic vascular resistance


    • Adaptive responses due to volume overload and increased systolic blood pressure (BP)


    • Increase left ventricular (LV) end-diastolic diameter with proportional increases in septal and free-wall thickness


  • Static exercise (e.g., weight lifting, bodybuilding) (2):



    • Increased peripheral resistance with smaller increases in heart rate and cardiac output


    • Increased septal and free-wall thickness without an increase in LV end-diastolic diameter


  • Combined exercise (e.g., cycling, rowing) (2):



    • Extreme volume and pressure load


    • Largest increase in LV end-diastolic diameter, septal wall, and free-wall thickness


RISK FACTORS



  • Chronic endurance exercise


  • Genetic predisposition


Mar 14, 2020 | Posted by in SPORT MEDICINE | Comments Off on Athletic Heart Syndrome
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