- Etiology
- Physiologic adaptation to training (Endurance → Eccentric; Resistance → Concentric).
- ↑ Vagal tone, ↓ Sympathetic tone.
- Clinical Features
- Asymptomatic.
- Sinus Bradycardia (< 50 bpm).
- S3 and Systolic ejection murmur are common/normal.
- Diagnostics
- ECG: Sinus bradycardia, LVH voltage criteria, 1st degree AV block.
- Echo: Symmetric wall thickening (< 15mm), Normal diastolic function, Dilated LV cavity.
- Ddx: Athlete’s vs. Hypertrophic Cardiomyopathy (HCM)
- Morphology: Athlete’s = Symmetric; HCM = Asymmetric septal hypertrophy.
- Cavity Size: Athlete’s = Dilated; HCM = Small.
- Deconditioning Trial: Cessation of training results in regression of LVH in Athlete’s heart (unchanged in HCM).
- Management
- Reassurance (benign). No restrictions.