Sports cardiac imaging: differentiating the athlete’s heart from underlying pathology

Athletic training results in a spectrum of morphologic and functional changes in cardiac structure and function that represent physiological adaptation to the increased cardiac output and changes in heart rate and blood pressure that accompany high levels of exercise. However, these structural changes may overlap with certain inherited cardiac diseases which constitute an important cause of sudden cardiac death during exercise in young adults. Sudden arrhythmic death syndrome (with a structurally normal heart) is the most prevalent cause of death, but underlying myocardial disease is not uncommon in large UK-based series. Early detection of these underlying abnormalities and appropriate counselling regarding abstinence from high intensity exercise is essential to prevent sudden cardiac death.

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