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A Patient With Athlete's Heart Syndrome: When the Abnormal Is Normal
Porfirio E Diaz-Rodriguez1, Victor H Molina-Lopez2, Benjamin A Gonzalez Burgos3
1Cardiology, Veterans Affairs Medical Center, San Juan, PRI.
Cureus
|April 15, 2024
Summary
Athlete's heart syndrome (AHS) involves heart changes from long-term athletic training. This case highlights AHS in a runner with cardiac remodeling and bradycardia, emphasizing the need to rule out other conditions.
Area of Science:
- Cardiology
- Sports Medicine
- Exercise Physiology
Background:
- Long-term athletic training induces cardiac remodeling, termed Athlete's heart syndrome (AHS).
- AHS is characterized by left ventricular (LV) enlargement and hypertrophy, common in endurance athletes.
- Conduction abnormalities like sinus bradycardia and atrioventricular (AV) block can occur due to parasympathetic influence.
Observation:
- A 66-year-old lifelong long-distance runner presented with severe sinus bradycardia, AV dissociation, and junctional escape rhythm.
- The patient also exhibited left ventricular hypertrophy (LVH) and T-wave repolarization abnormalities on ECG.
- Cardiac imaging and further studies were performed to exclude underlying cardiac pathologies.
Findings:
- The runner was diagnosed with Athlete's heart syndrome (AHS).
- Findings included significant cardiac remodeling and bradycardia attributed to prolonged endurance training.
- The case demonstrated rare, advanced conduction abnormalities in the context of physiological adaptation.
Implications:
- Distinguishing AHS from pathological heart conditions is crucial for appropriate management.
- Clinical evaluation, cardiac imaging, and electrophysiological studies aid in differentiating training adaptations from disease.
- This case emphasizes the importance of a comprehensive approach to diagnose and manage AHS in athletes.
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