July 30, 2020

Athletes With Enlarged Hearts: Is It Harmless or Serious?

The difference between athlete’s heart and serious medical issues

athlete runs up stairs in city

When you train your biceps, quadriceps or other muscle groups repeatedly over time, your muscles grow stronger, bigger and better equipped to deal with stress put on them.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Something similar happens with your heart, which is also a muscle. Regular cardiovascular exercise makes your heart more efficient at pumping blood to your body. In the case of athletes who do a lot of very high-intensity training, the heart sometimes actually gets a little bigger.

The term “athlete’s heart” refers to a natural, subtle enlargement that can happen as the heart adapts to intense athletic training. By itself, it’s not a disease or a medical condition and doesn’t cause harm.

However, an enlarged heart can also be a symptom of potentially serious heart problems such as hypertrophic cardiomyopathy, dilated cardiomyopathy or hypertension.

So when a serious athlete shows sign of an enlarged heart, it’s important for a physician to differentiate between athlete’s heart and a problem, say Co-Directors of Sports Cardiology Tamanna Singh, MD, and Michael Emery, MD. Sometimes it takes a sports cardiology expert to tell the difference.

Athlete’s heart or underlying condition?

Hypertrophic cardiomyopathy is a genetic disorder that causes the heart’s walls to slightly thicken. It’s a leading cause of sudden cardiac death in young athletes, so it’s important for athletes who have an enlarged heart to make sure they don’t have HCM.

Advertisement

A sports cardiologist looking to rule out HCM or another heart problem in an athlete would probably consider:

  • The sport’s unique demands and training techniques. “Sports-related changes to the heart are often particular to age, race, sex and type of sport,” says Dr. Emery. “All can have different ranges of ‘normal.’”
  • Results from tests such as an ECG, MRI, echocardiogram or stress test. “We are cautious in interpreting test results,” Dr. Singh says. “Most positive findings in athletes with no heart disease symptoms are false positives. That’s why we rarely rely on a single test. We will often design individualized stress tests that are specific to the athlete and the sport.”

Heart disease in athletes

Heart disease isn’t common in athletes, but if someone has concerning symptoms such as fainting, excessive shortness of breath, chest pain or an unexplained decline in performance, those should be checked out. A sports cardiologist will evaluate whether those symptoms are harmless symptoms related to the sport or something more serious.

If heart disease or another condition is diagnosed, it doesn’t necessarily mean the end of an athletic career.

“Detraining or quitting the sport is rarely necessary,” Dr. Singh assures. “Even athletes with a defibrillator can sometimes return to play. Sports cardiologists can discuss the pros and cons with the athlete and make a decision together.”

Advertisement

A cardiac exercise physiologist can also design an individualized exercise program with workouts that are safe for the athlete and effective for the sport.

“Our goal is to protect the heart, whether the patient is cleared to return to competition and training or directed toward noncompetitive activities,” Dr. Emery says.

Related Articles

spoon full of beetroot powder over sliced beets
June 25, 2023
Can Beetroot Powder Improve Athletic Performance?

The supplement can boost endurance and offer other benefits, including for sexual health

Young gymnast puts chalk on hands in a gym setting
August 9, 2021
Athletes and Mental Health: Breaking the Stigma

Why aren’t mental health issues taken as seriously as physical issues?

woman suffering from knee pain
December 21, 2020
8 Aches and Pains You Shouldn’t Ignore

Good pain or bad? Know the different kinds and when to seek help

Woman athlete cutting up fruit for a smoothie
January 2, 2020
Yes, You Can Be a Vegetarian and an Athlete Too

Eating right is key to maintaining your athletic performance

Doctor shaking hands with patient, with large heart and EKG line behind them
February 19, 2024
How Weight Affects Your Heart

Having underweight, having overweight and having obesity can be dangerous for your heart

Adult male using rowing machine at gym
February 16, 2024
Why Exercise Matters for Your Heart Health

Exercise lowers risk for heart conditions, improves mental health and reduces visceral fat that can compromise your organs

seated doctor and female in doctor office, with female's hand on heart, with daughter
February 8, 2024
Here’s When You Should Go to the Hospital for a Dangerous Heart Rate

A resting heart rate below 35–40 beats per minute or over 100 beats per minute may be cause for concern

beet and carrot juice in a glass surrounded by beets and carrots
February 1, 2024
Can Certain Drinks Lower Your Blood Pressure?

While not magic elixirs, some drinks like beet juice and skim milk may help keep numbers down

Trending Topics

glass of cherry juice with cherries on table
Sleepy Girl Mocktail: What’s in It and Does It Really Make You Sleep Better?

This social media sleep hack with tart cherry juice and magnesium could be worth a try

Exercise and diet over three months is hard to accomplish.
Everything You Need To Know About the 75 Hard Challenge

Following five critical rules daily for 75 days may not be sustainable

Person in foreground standing in front of many presents with person in background holding gift bags.
What Is Love Bombing?

This form of psychological and emotional abuse is often disguised as excessive flattery

Ad