Athlete’s heart: fit or unhealthy?

Athlete’s heart or Athletic Heart Syndrome (AHS) is usually a non-pathological change that occurs in people who exercise for extended periods of time, multiple days a week. Athletes are unarguably fit, but are they actually healthy? 

The science behind working out

When you work out, your muscles naturally need more blood and oxygen to perform properly. In order to meet the body’s increased oxygen requirements, the heart must pump more blood to the peripheral tissues of the arms and legs. When you train, your muscles get bigger, right? The same thing happens to the strong and muscular walls of the ventricles. The modifications in the structure of the heart are subtle, oftentimes asymptomatic. While these changes are seen to be purely adaptive and beneficial to the athlete, AHS might come along with some concerns to look after. 

Cross-sectional studies have shown that noticeable changes in wall thickness and chamber size would later lead to myocardial diseases. Athletes who undergo clinical examination may only complain about chest pain, but further examinations show a variety of signs that may be associated with AHS: bradycardia (40-60 bpm), cardiomegaly, or hypertrophy of the left ventricle. Although rare, a third heart sound (S3 gallop) can be heard through the stethoscope in this condition. A S3 gallop occurs after the two classic ‘lub-dub’ sounds and is sometimes associated with heart failure. In the vast majority of cases, enlarged hearts in athletes are considered an adaptation to effort. However, some elite sportspeople like Boston Celtic player Reggie Lewis have died suddenly from hypertrophic cardiomyopathy while playing basketball. 

Can too much fitness hurt?

50% of sudden cardiac deaths that occur in young sportsmen are caused by hypertrophic cardiomyopathy, a genetic disorder which is easily mistaken for AHS. Electrocardiogram results for athlete’s heart and hypertrophic cardiomyopathy may also appear similar so it is important to know the difference between these two. Healthcare providers may ask their patients to cease any intense physical activity for about three months and afterward check the heart again to make sure that there is no sign of cardiomyopathy. If after three months of rest the heart still appears to be enlarged, the patient may suffer from hypertrophic cardiomyopathy. The treatment for this disease can range from basic medication and lifestyle changes to cardiothoracic surgery depending on the situation. During such surgery, the thickened walls of the heart can be ‘scraped’ away in order to improve blood flow.

Staying active along with eating well and getting enough sleep are key elements to living a long and thriving life. But exercising too much can become harmful at some point. Working out for 2.5-3 hours per week is ideal to stay healthy and in good shape. But getting past 5-6 hours of training per week is no longer exercising for health, but for performance. Gaining a pleasant physical appearance may be considered essential to some, but so are your heart and your life. 

If you found this article interesting you can read the full version here. You should also read our previous article! Stay safe, stay healthy, stay curious! See you next time.

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