Athletic Heart Syndrome

Athletic Heart Syndrome

Evan D. Perez, MD

Daniel Murphy, MD, FAAFP

Justin M. Wright, MD, CAQSM



  • 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


  • 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


  • 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


  • Chronic endurance exercise

  • Genetic predisposition

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