Athlete's Heart

What is athlete’s heart?

Athlete’s heart is the name for the changes that happen in your heart when you do strenuous exercise for more than one hour on most days of the week. Most of the time, these changes aren’t excessive. However, in some athletes, the changes can make your heart look similar to how it looks when you have a form of cardiomyopathy. Because cardiomyopathy isn’t harmless, your provider needs to know what makes athlete’s heart different.

What’s the difference between athlete’s heart and hypertrophic cardiomyopathy?

Some electrocardiogram results appear similar for these two conditions. It’s important to know the difference because one is dangerous and the other isn’t.

Hypertrophic cardiomyopathy

• Can cause sudden cardiac death in athletes.
• The amount of space inside of your left ventricle gets smaller.
• Left ventricle wall is thicker than in people with athlete’s heart.

Athlete’s heart

• Doesn’t cause sudden cardiac death in athletes.
• The amount of space inside of your left ventricle gets bigger.
• Left ventricle wall is thick, but not as thick as in people with hypertrophic cardiomyopathy.

Who does athlete’s heart affect?

Athlete’s heart affects 2% of athletes. This can happen after years of strenuous training. Athlete’s heart is much more common in athletes who are Black than in people of other races.

How does athlete’s heart affect my body?

Your body needs more oxygen when you exercise. To meet this higher demand, your heart’s left ventricle handles more blood and a higher pressure than normal. Your left ventricle pumps oxygen-rich blood to your aorta, which sends it out to your body.

After meeting your body’s need for more blood and oxygen for a while, your left ventricle starts to get bigger and develop thicker heart muscle.

When you’re not working out, your heart doesn’t have to pump as much blood. It can pump what you need at a lower heart rate. This is why people with athlete’s heart syndrome have a heart rate that’s lower than a non-athlete’s heart rate at rest.

What are the symptoms?

There aren’t any athletic heart syndrome symptoms. You most likely have a different heart issue if you have chest pain or palpitations.

What causes athletic heart syndrome?

Intense endurance training or strength training can be athletic heart syndrome causes in some athletes.

Endurance sports tend to increase the size and wall thickness of an athlete’s left ventricle.

Sports that can lead to athlete’s heart include:

• Rowing.
• Swimming.
• Cross-country skiing.
• Cycling.

How do you know if you have athlete’s heart?

A healthcare provider can diagnose you based on athlete’s heart syndrome signs and symptoms, such as:

• A heart murmur that your provider can hear through their stethoscope.
• Extra heartbeat sounds that aren’t normally there.
• Slow heart rate (bradycardia).
• Lower blood pressure.

What tests will be done to diagnose athlete’s heart?

Tests to diagnose athlete’s heart include:

• Electrocardiogram (EKG). Unusual results happen while at rest but not during exercise in people with athlete’s heart.
• Echocardiogram.
• Chest X-ray.
• Cardiopulmonary exercise testing.
• Heart MRI (rarely used for this).
• Stress test (rarely used for this).

How do you treat athlete’s heart?

You don’t need treatment for athlete’s heart syndrome. However, your healthcare provider may ask you to stop training for three months and reimage your heart to ensure you don’t have cardiomyopathy.

Does athlete’s heart go away?

Yes. In most people, your heart returns to a normal size after you stop training so hard. However, a study found that 20% of former athletes still had a large left ventricle five years later.

How can I reduce my risk?

Because athlete’s heart is the heart’s normal response to intense, aerobic exercise, you don’t need to reduce your risk because it’s not a dangerous condition.

What can I expect if I have athlete’s heart?

Exercise is good for your heart, and people with an athletic heart don’t have problems from it later. A study of high-level athletes found that their endurance training didn’t cause heart issues in the future.

How long athlete’s heart lasts

Athlete’s heart continues as long as you don’t ease up on your training. After three months without training, your heart goes back to normal.

When should I see my healthcare provider?

Contact a healthcare provider if you have these symptoms:

• Fainting.
• Chest pain.
• Heart palpitations.

While these aren’t linked to athlete’s heart, they could mean you have coronary artery disease or cardiomyopathy.

When should I go to the ER?

You should call 911 if you think you may be having a heart attack. You should also call 911 if you see someone collapse and not respond.

What questions should I ask my doctor?

• Do I need to be screened for heart issues?
• How often should someone check my heart health?
• Did you see anything in my test results that mean my family should be checked for heart issues?

A note from Cleveland Clinic

If your healthcare provider thinks you may have a type of cardiomyopathy instead of athlete’s heart, they may ask you to stop training so they can be sure. If this happens, ask them if there are other tests they haven’t tried yet. If they’ve done all the tests they can but still suspect you may have cardiomyopathy, it can be tough to give up training to see if your heart goes back to normal. Consider your health and your future. Talk with your provider about it. Sports may be important to you, but your life is, too.