Although a link between intensive exercise and exercise-induced arythmogenic right ventricular cardiomyopathy exists.No treatment is required for people with athletic heart syndrome; it does not pose any physical threats to the athlete, and despite some theoretical concerns that the ventricular remodeling might conceivably predispose for serious arrhythmias, no evidence has been found of any increased risk of long-term events. Athletes should see a physician and receive a clearance to be sure their symptoms are due to athletes heart and not another heart disease, such as cardiomyopathy. If the athlete is uncomfortable with having athletes heart or if a differential diagnosis is difficult, deconditioning from exercise for a period of three months allows the heart to return to its regular size. However, one long-term study of elite-trained athletes found that dilation of the left ventricle was only partially reversible after a long period of deconditioning. This deconditioning is often met with resistance to the accompanying lifestyle changes. The real risk attached to athletes heart is if athletes or nonathletes simply assume they have the condition, instead of making sure they do not have a life-threatening heart illness. History
The athletes heart syndrome was first described in 1899 by Salomon Henschen. He compared the heart size of cross-country skiers to those who lived sedentary lives. He noticed that those who participated in competitive sports displayed symptoms of athletes heart syndrome. Henschen believed the symptoms were a normal adjustment to exercise, and felt concern was not needed.
Diagnosis
Athletes heart is usually an incidental finding during a routine screening or during tests for other medical issues. An enlarged heart can be seen at echocardiography or sometimes on a chest X-ray. Similarities at presentation between athletes heart and clinically relevant cardiac problems may prompt electrocardiography (ECG) and exercise cardiac stress tests. The ECG can detect sinus bradycardia, a resting heart rate of fewer than 60 beats per minute. This is often accompanied by sinus arrhythmia. The pulse of a person with athletes heart can sometimes be irregular while at rest, but usually returns to normal after exercise begins.Regarding differential diagnosis, left ventricular hypertrophy is usually indistinguishable from athletes heart and at ECG, but can usually be discounted in the young and fit.It is important to distinguish between athletes heart and hypertrophic cardiomyopathy (HCM), a serious cardiovascular disease characterised by thickening of the hearts walls, which produces a similar ECG pattern at rest. This genetic disorder is found in one of 500 Americans and is a leading cause of sudden cardiac death in young athletes (although only about 8% of all cases of sudden death are actually exercise-related). The following table shows some key distinguishing characteristics of the two conditions.Athletes heart should not be confused with bradycardia that occurs secondary to Relative energy deficiency in sport or Anorexia nervosa, which involve slowing of metabolic rate and sometimes shrinkage of the heart muscle and reduced heart volume.