Imaging of cardiopulmonary diseases

Clear physiologic adaptations to endurance and resistance training occur in the myocardium. These morphologic changes have been identified primarily by echocardiography. In the evaluation of the symptomatic athlete, imaging is a valuable tool. To differentiate athletic hypertrophy from hypertrophic cardiomyopathy, echocardiography, or MRI may be used, although the latter may be superior in the accurate assessment of wall thickness. Either imaging modality may be used to differentiate athletic dilatation from dilated cardiomyopathy in which systolic dysfunction always accompanies the dilatation. To exclude anomalous coronary arteries, either MRI or CT is a reasonable examination, although the latter requires x-ray exposure and iodinated contrast dye. Chest radiograph continues to be the standard imaging modality for athletic lung disease, whereas fluoroscopy and laryngoscopy are useful for identifying vocal cord dysfunction. Knowledge of the utility of these different imaging modalities is crucial to the practitioner of sports medicine.