[Ten questions about the athlete's heart: a guide for the clinical cardiologist].

Abstract

The athlete's heart is a complex physiological adaptation to sustained physical training, necessitating a specialized approach to diagnosis and management. Advanced cardiac imaging plays a pivotal role in differentiating physiological remodeling from pathological conditions such as cardiomyopathies. In particular, cardiac magnetic resonance is essential for detecting subclinical myocardial fibrosis and other structural abnormalities that may indicate underlying disease. Serial imaging during follow-up is valuable for monitoring the progression or regression of cardiac remodeling, especially during periods of detraining, and is key to confirming the physiological nature of observed changes. Early identification of high-risk features, including complex arrhythmias or structural abnormalities, is critical for preventing adverse outcomes such as sudden cardiac death.