Differentiating Athlete's Heart From Cardiomyopathies - The Left Side

Heart Lung Circ. 2018 Sep;27(9):1052-1062. doi: 10.1016/j.hlc.2018.04.297. Epub 2018 May 16.


In athletes who undertake a high volume of high intensity exercise, the resultant changes in cardiac structure and function which develop as a result of physiological adaptation to exercise (so called "Athlete's Heart") may overlap with some features of pathological conditions. This chapter will focus on the left side of the heart, where left ventricular cavity enlargement, increase in left ventricular wall thickness and increased left ventricular trabeculation associated with athletic remodelling may sometimes be difficult to differentiate from conditions such as dilated cardiomyopathy, hypertrophic cardiomyopathy or isolated left ventricular non-compaction. The distinction between physiological versus pathological changes in athletes is imperative as an incorrect diagnosis can have important consequences, such as exclusion from competitive sport, or false reassurance and missed opportunity for effective therapeutic intervention.

Keywords: Athlete’s Heart; Dilated cardiomyopathy; Hypertrophic cardiomyopathy; Left ventricular non-compaction.

Publication types

  • Review

MeSH terms

  • Athletes*
  • Cardiomegaly / diagnosis*
  • Cardiomegaly / physiopathology
  • Cardiomyopathies / diagnosis*
  • Cardiomyopathies / physiopathology
  • Diagnosis, Differential
  • Echocardiography*
  • Electrocardiography*
  • Exercise / physiology*
  • Heart Ventricles / physiopathology
  • Humans
  • Ventricular Function, Left / physiology*