ABC Imagem Cardiovasc. 2025; 38(3): e20250059
Between the Physiological and the Pathological Spectra: When the Athlete’s Heart Demands More Than Admiration
DOI: 10.36660/abcimg.20250059i
The increasing participation in high-intensity sports has expanded the role of cardiology in athlete screening and monitoring. Although Sudden Cardiac Death (SCD) is rare, it has a deep impact on society as a whole. Echocardiography is central in this setting, serving as the primary imaging modality to distinguish physiological remodeling in the athlete’s heart from structural cardiomyopathies.
Prolonged and intense exercise induces adaptive phenotypic and physiological changes that enhance myocardial performance. These adaptations, known as “athlete’s heart,” are extensively studied because they need to be differentiated from potentially fatal cardiovascular diseases.– The Athlete’s Heart shares phenotypic characteristics with several pathological conditions, such as Hypertrophic Cardiomyopathy (HCM), Dilated Cardiomyopathy (DCM), and Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC). Cardiologists need to be aware of these overlaps to correctly diagnose and prevent serious outcomes, especially in young, apparently healthy individuals, who may not experience symptoms until they engage in intense exercise. Equally important is the ability to identify normal adaptive cardiac remodeling, thereby enabling precise screening and appropriate guidance for elite athletes.
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