Athletes and Enlarged Hearts

Non-fatal condition or potentially dangerous HCM

A diagnosis of an enlarged heart in athletes may be a serious medical issue – or just a byproduct of an active lifestyle. The challenge for physicians is to differentiate between the two.

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About athlete’s heart

The physical demands placed on the body can trigger an athlete’s heart to grow in size. This condition is called “athlete’s heart” and is non-fatal.

Cleveland Clinic’s Milind Desai, MD, an expert in athlete’s heart, explains athletes can “develop enlarged hearts with slightly thicker muscle walls and lower heart function due to their high endurance sporting activities.”

Stopping all high endurance activities for 3-6 months should tell the difference between athlete’s heart and HCM.

Athlete’s heart or HCM

Though athlete’s heart is a non-fatal condition, it is often confused with a potentially dangerous condition called hypertrophic cardiomyopathy, or HCM. The two can be difficult to tell apart.

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How to tell between the two

In athlete’s heart and HCM, the walls of the heart become slightly thicker and heart function can be borderline low. Both conditions can be identified by advanced cardiac imaging tests. But unlike HCM, athlete’s heart causes no symptoms. 

According to Dr. Desai, the definitive way to differentiate between the two is to stop all high endurance activities for 3-6 months and then remeasure the heart.

“By stopping the high endurance activities has the heart wall thickness come down? Has the heart size shrunk? If the answers are yes, then we know this is indeed athlete’s heart and not hypertrophic cardiomyopathy,” Dr. Desai explains.

Dr. Desai’s advice to concerned athletes

An undiagnosed case of HCM has the potential to be fatal. And a case of athlete’s heart misdiagnosed as HCM could end a promising athletic career prematurely.

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Dr. Desai advises anyone with a suspected case of HCM or athlete’s heart to seek out an accurate diagnosis at a center of excellence. Once cleared by their doctors, players with athlete’s heart should have no fear of returning to normal sports and activities.

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