What Is Athlete's Heart?

Professional athletes who have undergone long-term exercise exercise have morphological and functional changes in their heart, including cardiac hypertrophy, enlarged heart, slow heart rate, "ischemic" changes in the electrocardiogram, and recovery after stopping exercise. Whether these changes are pathological is still controversial, so it can also be called athlete's heart syndrome.

Basic Information

nickname

Athlete Heart Syndrome

Visiting department

Cardiac Surgery

Common locations

heart

Common causes

Related to sports

Common symptoms

No conscious symptoms. The heart rate can be less than 40 beats / minute in the resting state, the heart dullness circle expands to the lower left, the blood pressure is low, and auscultation may have arrhythmia

1. During exercise, sympathetic nerves excite, catecholamine secretion increases, heart rate accelerates, myocardial contractility increases, stroke volume, cardiac output increases, and heart volume increases.
2. During exercise, the blood vessels in the extremities dilate and the resistance decreases, which is conducive to venous return. The muscles of the extremities contract in rhythm, promote venous return, increase the heart volume, increase myocardial fibers, and myocardial hypertrophy.
3. During long-term training, the vagus nerve tension in the resting state of the athlete is increased, the heart rate is slowed down, and even the atrioventricular block and blood pressure are low.

No conscious symptoms. In resting state, the heart rate can be <40 beats / minute, the heart dullness circle expands to the lower left, the blood pressure is low, arrhythmia may have arrhythmia, the third heart sound, the fourth heart sound are less heard, and the left margin of the sternum can be heard and the systole Jet-like noise, reduced when standing upright.

1. ECG axis changes, mostly sinus bradycardia, often accompanied by sinus arrhythmia, may have a walking heart rate. Visible atrial or ventricular premature contractions, first or second degree atrioventricular block, right bundle branch block. The QRS wave amplitude increases, the ST segment rises, and the T wave is flat or inverted.
2. Echocardiography endurance athletes have a whole heart enlargement, the left ventricular cavity and right ventricular cavity are enlarged significantly, accompanied by thickening of the heart wall; strength event athletes' cardiac hypertrophy is mainly left ventricular myocardial hypertrophy, and left and right ventricular enlargement obvious.
3. X-ray examination increases the heartbeat amplitude and heart shadow.
4. The radionuclide perfusion imaging of myocardium is evenly distributed.

Professional athletes or heavy manual laborers have myocardial hypertrophy, slow heart rate, low blood pressure, but no symptoms. After stopping training or manual labor for a period of time, the ECG changes disappear and the diagnosis can be made.

1. Hypertrophic cardiomyopathy Hypertrophic obstructive cardiomyopathy The ratio of the ventricular septum to the posterior wall of the left ventricle is> 1.3 to 1.5; and the athlete's heart is <1.2. The left ventricle diameter of hypertrophic cardiomyopathy is 55mm longer. Hypertrophic cardiomyopathy often enlarges the left atrium and the left ventricular filling function is abnormal; athletes' hearts rarely have left atrial enlargement and the left ventricular filling function is normal. Electrocardiograms of hypertrophic cardiomyopathy are complex. After stopping training, myocardial hypertrophy in the athlete's heart will decrease, but hypertrophic cardiomyopathy will not. Hypertrophic cardiomyopathy has a clear family history, and athletes have no family history.

The simple athlete's heart syndrome does not require special treatment, and after a long period of complete stop training, it can basically recover to the pre-training level. People with discomfort should be advised to reduce strenuous exercise and perform related tests.

The prognosis is good. With the end of regular exercise training, myocardial remodeling will be reversed to varying degrees. However, athletes are still likely to suffer from cardiovascular disease. Those who are at high risk of cardiovascular disease or who have cardiovascular symptoms should be screened for cardiovascular disease.

It is recommended that athletes be screened for cardiovascular disease at the beginning of their sports career to prevent and reduce sudden death.