Athlete’s heart


What is it about ?

The term “athlete’s heart” refers to changes in the heart that occur after heavy or prolonged training. These can be changes in the structure of the heart (the muscle and size of the heart) and in the electrical activity of the heart (the heartbeat). Usually, the changes are reversible, which means they may go away when you stop training hard.

What are the characteristics?

Structural alterations

These changes mainly occur in the left ventricle, which can thicken (hypertrophy). They mainly concern endurance athletes (eg cyclists) and to a lesser extent those who do weight training (eg weightlifters). The muscle of the heart (also called the myocardium) can thicken, especially in people who do weight training. These two changes can also occur simultaneously.

Change in electrical activity

The most characteristic aspect is the slow heart rate, which can sometimes drop to 30 beats per minute. This slowing down occurs mainly at rest and at night, and disappears with exertion.
An ECG (electrocardiogram) shows electrical activity. In the presence of an “athlete’s heart”, changes in the ECG may be observed, such as slow heartbeat (bradycardia) Where intermittent.

Interpretation

Changes in the heart after heavy training are not a sign of heart disease. It is nothing more than a way for the heart to adapt and cope with a heavier load. Moreover, these adaptations do not cause symptoms. But sometimes it is difficult to distinguish these alterations from the underlying heart disease. This is why it is advisable, if necessary, to undergo a preventive examination of the heart by a specialist doctor.

So a thickening of the muscle of the heart (hypertrophic cardiomyopathy) may be due to prolonged training, but just as easily tohypertension or to a heart muscle disease (heart disease) in itself. It is absolutely crucial to know the abnormalities potentially visible on the electrocardiogram (ECG) in sportsmen and women in order to be able to differentiate an athlete’s heart from possible heart disease.

The discovery of slight anomalies which do not give rise to complaints is not a reason for prohibiting the practice of a sport. On the other hand, extreme efforts will be discouraged, and in some cases it will be necessary to pass additional examinations to find the cause.

If symptoms occur while playing sports, eg. chest pain or palpitations, think of a heart defect. In this case, additional examinations are necessary.

Source

Foreign clinical practice guide ‘Cœur d’athlète’ (2014), updated on 11.04.2016 and adapted to the Belgian context on 12.21.2019 – ebpracticenet