Some athletes develop structural changes to the heart which may be confused with a cardiomyopathy.

History given: prolonged and strenuous athletic training


Features of the athlete's heart:

(1) left ventricular hypertrophy with increased left ventricular mass

(2) low heart rate

(3) increased pumping capacity


Features distinguishing athlete's heart from other heart diseases:

(1) negative genetic tests for a hereditary disorder

(2) normal geometric indices on cardiac magnetic resonance imaging studies


Features that may be clues to an underlying cardiomyopathy (Czimbalmos et al):

(1) EDWT (end-diastolic wall thickness) between 13-16 mm

(2) abnormal ECG (pathologic Q wave, T wave inversion, etc)

(3) diastolic dysfunction

(4) abnormal apical morphology

(5) intramural fibrosis

(6) abnormal sport indices (EDWT to LVEDVi ratio; LVM/LVEDV ratio; etc)

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