Did you know that when we exercise a lot, especially if we do strenuous exercise for more than an hour a day, our heart can experience certain changes? This is what we call "Athlete's Heart." Most of the time, these changes are not dangerous, but sometimes these symptoms can be similar to those of other heart diseases, so it's important to be aware of them.
What is the difference between athlete's heart and hypertrophic cardiomyopathy?
Since some of the test results (Electrocardiogram - EKG) for both can look the same, it is very important to know the exact difference between the two. Because one is dangerous, and the other is not.
What is Hypertrophic Cardiomyopathy?
Come to think of it, this is a bit of a serious situation.
- This can cause players to die from sudden cardiac death.
- The space inside your heart's left ventricle shrinks.
- The wall of the left ventricle is much thicker than the wall of the heart of someone with an athlete's heart.
So what is Athlete's Heart?
This is nothing to be afraid of.
- This will not cause players to die of sudden heart attacks.
- The space inside the left ventricle of your heart becomes larger.
- The wall of the left ventricle thickens, but not as much as in hypertrophic cardiomyopathy.
Who gets this condition called athlete's heart?
Simply put, this condition, known as "athlete's heart," affects about 2% of athletes. It doesn't happen overnight. It's most common in people who have been training hard for years, meaning they're doing intense exercise for most of the day. For example, think of marathon runners, long-distance swimmers, and cyclists. Some studies suggest that the condition is more common among black athletes than other races.
How does athlete's heart affect your body?
Think about it, when you're running, swimming, or doing any other strenuous exercise, your muscles need more oxygen than usual, right? So, to meet this increased need for oxygen, your heart has to work a little harder. Specifically, your heart's left ventricle—the main chamber that pumps oxygen-rich blood to the rest of your body—starts pumping more blood than usual, under higher pressure. This left ventricle is what distributes the oxygen-rich blood to the rest of your body through the aorta.
So, as you continue to work day after day to meet your body's need for more blood and oxygen, just like a weightlifter's muscles get bigger, your left ventricle also starts to get bigger and the walls of your heart muscle get thicker . This is how the heart adapts to the new challenge.
However, when you are at rest, your heart does not need to pump as much blood. Therefore, the heart can easily pump the blood needed by the body even at a low heart rate. This is the main reason why people with an athlete's heart have a significantly lower resting heart rate than the average person. This is because the heart works more efficiently.
What are the symptoms of this?
Here's something that surprises many people, and it's important to know. There are actually no specific symptoms for athletic heart syndrome. That means that even if you have this condition, you may not feel any discomfort, pain, or discomfort.
However, if you experience chest pain, shortness of breath, palpitations, or fainting during exercise, it is not just athlete's heart. It is likely another heart condition, possibly a serious one. So if you have such symptoms, don't take them lightly. It is always wise to see a doctor and get checked out.
What are the causes of athlete's heart?
Typically, some athletes develop this condition called athlete's heart after intense endurance training or strength training. That is, long-distance running, hours of swimming, and cycling.
In particular, endurance sports are the most likely to increase the size and wall thickness of an athlete's left ventricle, because in such sports the heart has to pump blood for a long time.
Here are some games that can spark this athletic spirit:
- Rowing
- Swimming
- Cross-country skiing - Although this is not as popular in Sri Lanka, this is also an example.
- Cycling
- Long-distance running
How do you know if you have a sportsman's heart?
This is not something you can diagnose at home. A doctor can only determine this for sure. They will examine you, ask you about your sports, how long you train, etc. In addition, there are some signs they will look for:
- A heart murmur is an abnormal heart sound that is heard when the doctor listens to your chest with a stethoscope.
- Extra heartbeat sounds that are not normally present in a healthy heart.
- Slow heart rate (bradycardia) at rest – that is, less than 60 beats per minute.
- Blood pressure slightly lower than normal.
What tests are done to confirm this?
If the doctor has any suspicions, they may perform several tests to confirm them and make sure that this is not another dangerous heart condition:
- Electrocardiogram (EKG/ECG): This measures the electrical activity of the heart. People with athlete's heart may show some abnormalities at rest, but these symptoms disappear with exercise.
- Echocardiogram: This is like an ultrasound scan of the heart. It can clearly see many things like the size of the heart's chambers, the thickness of the walls, and how the valves are working. This is very important to distinguish between athlete's heart and dangerous conditions like the aforementioned Hypertrophic Cardiomyopathy.
- Chest X-ray: This can give a rough idea of the size and shape of the heart.
- Cardiopulmonary exercise testing: This involves running on a treadmill and watching how your heart and lungs respond to exercise.
- Heart MRI: This is rarely used to diagnose this condition.
- Stress test: This is also rarely used.
How is athlete's heart treated?
Here's more good news! Athlete's heart syndrome doesn't actually require any special treatment. Because it's not a disease, it's a normal, healthy response of the heart to exercise.
However, if your doctor has any doubts about whether you really have athlete's heart or another heart condition, such as cardiomyopathy, to confirm, he or she may ask you to stop strenuous exercise for about three months. Then, they will do another test, such as an echocardiogram, to see if your heart has decreased in size or if there have been any changes.
Is this player's heart going away?
Yes, it often does. After most athletes stop their intense training, or reduce the intensity of their training, their hearts gradually return to normal size and thickness. This can take several months.
However, one study found that about 20% of former high-level athletes still had a slightly enlarged left ventricle about five years after they stopped training completely. But they didn't report any side effects.
How can I reduce the risk of this?
Athlete's heart is a normal and healthy response of the heart to intense, aerobic exercise, so it is not a dangerous condition. Therefore, there is no need to do anything special to "reduce the risk." In fact, some people consider it a sign of a strong heart.
If I have a sportsman's heart, what should I expect?
If a doctor tells you that you have athlete's heart, don't worry about it. Exercise is very good for your heart. People with an athlete's heart are less likely to develop heart disease later in life. In fact, a study of high-level athletes found that their endurance training did not prevent them from developing heart disease later in life. There is also evidence that they live longer, healthier lives than the average person.
How long does the athlete's heart last?
It's very simple. Athlete's heart can persist as long as you continue to train hard. Whether you reduce the intensity of your training or stop it altogether, your heart will return to its normal size and thickness within about three months.
When should I see a doctor?
This is the most important part. Although athlete's heart is not dangerous, there are some symptoms that you should definitely see a doctor if you have them. Because those symptoms could be a sign of another serious heart condition.
Those symptoms are:
- Sudden fainting, especially during or after exercise.
- Chest pain or a feeling of tightness in the chest.
- Feeling your heart beating fast/heart palpitations, if it is causing you discomfort.
- Feeling more breathless than usual when exercising.
Remember, these symptoms are not related to athlete's heart. They could indicate that you have coronary artery disease or a dangerous heart condition like the one we talked about earlier (cardiomyopathy). So be very careful about these symptoms, and if you have them, see a doctor without delay.
When should I go to an Emergency Treatment Unit (ETU) ?
If you feel like you are having a heart attack (e.g., severe pain in the center of the chest, radiating to the arm, neck, jaw, sweating, nausea), call 1990 (Sri Lanka's emergency ambulance service) without delay. Also, if you see someone suddenly collapsed, unconscious, and unresponsive, call emergency services immediately and ask for help.
What questions should I ask my doctor?
If your doctor thinks you may have a different type of cardiomyopathy than athlete's heart, or if they suspect otherwise, they will tell you to stop training for a while to get the exact condition checked. If that's the case, don't panic, and ask your doctor about the following:
- "Are there any other tests I can try to find out more about this situation?"
- "If you stop training, how long will it take to get tested again?"
Sometimes, even after doctors have done all the tests they can, if there is still the slightest suspicion that you may have cardiomyopathy, it can be emotionally difficult for you to stop training for a while to see if your heart returns to normal. Sports may be a big part of your life.
But, think about your health and your future. Talk to your doctor about this openly and honestly. No matter how important sports are to you, your life is even more important, right?
Some common questions you can ask your doctor include:
- Do I need to have regular screenings for heart disease?
- How often should I have my heart health checked?
- Is there anything in my test reports that says other members of my family (mother, father, siblings) should be tested for heart disease? (This is important because some heart diseases are hereditary.)
So, what is the take-home message for us from this story?
Simply put, if you are someone who works out a lot, especially endurance exercise, it is normal for your heart to experience some changes. This is called "Athlete's Heart." This is not a serious condition. In most cases, it does not require treatment, and the heart will return to normal when you reduce the intensity of your training or stop.
However, it is very important to distinguish this from dangerous heart diseases like Hypertrophic Cardiomyopathy. Because, those conditions require prompt treatment. Therefore, if you have symptoms like chest pain, shortness of breath, unusual difficulty breathing, or a pounding in the chest, remember that these are not symptoms of athlete's heart, and definitely seek medical advice. Whenever you have any doubts, it is best to talk to a doctor and get tested for your peace of mind and your safety.
Remember, exercise is essential for a healthy life, but doing it safely and consciously is even more important!
` Athlete's heart, exercise, heart health, hypertrophic cardiomyopathy, heart rate, heart tests, sports medicine
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