The athlete's heart: clinical, electrocardiographic and echocardiographic findings

pp 126-137

Abstract

The practice of high performance sports induces cardiovascular adaptations reflected in diverse clinical, electrocardiographic and echocardiographic changes. The sports cardiologist role is very important, not only in the follow-up of the athlete with heart disease, but also in the evaluation of health and suitability conditions for practicing sports. His/her involvement in the athlete's training has permitted the understanding of the processes which take place in training and the nature of the stimuli needed to maximize the performance of diverse metabolic areas. The particular features of the athlete's heart result from modifications in cardiac morphology and function, as well as from changes in the autonomic nervous system. The electrocardiogram can exhibit rhythm alterations, atrioventricular, intra atrial and intraventricular conduction disturbances, increased QRS voltage and diverse modifications of ventricular repolarization. Morphological changes detected by echocardiography are not -in general terms- quite evident, and are mostly related with increased chamber diameters and wall thick-ness. The clinical, electrical and echocardiographic findings may lead to confuse the athlete's heart with diverse pathologic conditions. Since these changes are not uniform among athletes with similar age and training, genetic factors are thought to be involved in their occurrence. The present review describes the most common findings in the medical examination of the athlete's heart, and discusses their prevalence and clinical significance.