The Electrocardiogram (ECG) in the Athlete

Athlete`s Heart or Athletic Heart Syndrome is a benign entity characterized by morphological changes of the heart muscle as a result of long-term adaptation to exercise. The hallmark of these alterations is a substantial enlargement of the heart due to both heart chamber dilatation and heart muscle mass hypertrophy. Although athlete’s heart has long been considered as a benign condition, there are data suggesting an association with sudden cardiac death (SCD) which can occur in athletes during exercise or even during daily activities. Indeed, hypertrophic cardiomyopathy (HCM), also characterized by marked cardiac hypertrophy, is the most common cause of SCD in young athletes. The association between HCM and athlete’s heart has been a matter of extensive discussion and debate among clinicians since an eccentric biventricular hypertrophy is almost universally present in athletes with a left ventricular diastolic volume >58 mm. This conflict has not yet been resolved, but, we have nowadays evidence that the ECG, although commonly altered by athletic cardiac remodeling, can assist in selecting athletes who are at substantial risk for an episode of SCD... (excerpt