Athlete's Heart: A Cardiovascular Step-By-Step Multimodality Approach

“Athlete’s heart” is a spectrum of morphological, functional, and regulatory changes that occur in people who practice regular and long-term intense physical activity. The morphological characteristics of the athlete’s heart may overlap with some structural and electrical cardiac diseases that may p...

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Bibliographic Details
Main Authors: Stefano Palermi, Elena Cavarretta, Flavio D’Ascenzi, Silvia Castelletti, Fabrizio Ricci, Marco Vecchiato, Alessandro Serio, Luna Cavigli, Eduardo Bossone, Giuseppe Limongelli, Alessandro Biffi, Emanuele Monda, Andre La Gerche, Aaron Baggish, Antonello D’Andrea
Format: Article
Language:English
Published: IMR Press 2023-05-01
Series:Reviews in Cardiovascular Medicine
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Online Access:https://www.imrpress.com/journal/RCM/24/5/10.31083/j.rcm2405151
Description
Summary:“Athlete’s heart” is a spectrum of morphological, functional, and regulatory changes that occur in people who practice regular and long-term intense physical activity. The morphological characteristics of the athlete’s heart may overlap with some structural and electrical cardiac diseases that may predispose to sudden cardiac death, including inherited and acquired cardiomyopathies, aortopathies and channelopathies. Overdiagnosis should be avoided, while an early identification of underlying cardiac life-threatening disorders is essential to reduce the potential for sudden cardiac death. A step-by-step multimodality approach, including a first-line evaluation with personal and family history, clinical evaluation, 12-lead resting electrocardiography (ECG), followed by second and third-line investigations, as appropriate, including exercise testing, resting and exercise echocardiography, 24-hour ECG Holter monitoring, cardiac magnetic resonance, computed tomography, nuclear scintigraphy, or genetic testing, can be determinant to differentiate between extreme physiology adaptations and cardiac pathology. In this context, cardiovascular imaging plays a key role in detecting structural abnormalities in athletes who fall into the grey zone between physiological adaptations and a covert or early phenotype of cardiovascular disease.
ISSN:1530-6550