- 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)
| Feature | Hypertrophic Cardiomyopathy (HCM) | Athlete’s Heart |
|---|
| Family history | Common | Usually unremarkable |
| ECG findings | LVH criteria + depolarization &/or repolarization abnormalities* | LVH criteria without other abnormalities |
| Left atrial size | Enlarged | Normal |
| LV cavity size | Usually decreased | Slightly enlarged |
| LV wall thickness | ≥15 mm | <15 mm |
| Focal septal hypertrophy | Yes | No |
| LV diastolic function | Impaired | Normal |
- Management
- Reassurance (benign). No restrictions.