​Sports and the Heart

Exercise is considered to be one of the most important ways to keep your heart healthy. It has been well documented that it reduces cardiovascular disease, lowers blood pressure in the long term, improves blood glucose control in diabetics, and helps improve the level of your cholesterol. It also helps control your weight and physical fitness.
With regular aerobic exercise of significant amounts (at least one hour for most days of the week) the heart undergoes some structural and functional changes which reflect its improved efficiency. These changes are NOT PATHOLOGICAL and require no treatment if identified in an individual who exercises regularly. In medical terms this constellation of changes are often referred to as"Athlete's heart" which is not a disease and is not dangerous!
 The heart increases slightly in size and the heart muscle becomes slightly thicker. The heart rate in individuals who exercise regularly is lower and their ECG may show specific changes.
It is important to stress that these "changes" are considered normal only in individuals who are involved with significant amounts of exercise, otherwise further investigations may be required to exclude pathological conditions such as cardiomyopathy which requires treatment.  
In cardiomyopathy the ECG changes may be similar to those in "Athlete's heart" and it is of vital importance to distinguish between the two conditions. This is the reason why individuals who participate in competitive sports require screening with a medical assessment, ECG and often an Echocardiogram in order to identify potential heart problems.
"Athlete's heart" and cardiomyopathy can be distinguished with an echocardiogram but sometimes other investigations might be required such as Exercise stress testing or Holter monitor.
Screening athletes for heart problems is essential to diagnose specific heart conditions and prevent sudden cardiac death which is an extremely rare phaenomenon in athletic activity. Some of the causes of sudden cardiac death associated with athletic activity include cardiomyopathy, aortic stenosis, arrhythmia, coronary artery disease, aortic aneurysm and congenital heart disease.
The distinction between athlete's heart and cardiomyopathy can sometimes be difficult even with the use of an echocardiogram but a detailed assessment including family history, ECG, exercise stress testing should be able to distinguish between the two.
If there is uncertainty despite a complete assessment, discontinuation of heavy exercise reverses the structural changes of the heart only in the case of athlete's heart, whereas in the case of cardiomyopathy these changes persist.