Structural and functional adaptations in the athlete’s heart

Cardiac changes in athletes have been described for more than a century, with initial observations derived by chest percussion and chest X-rays. Recent advances in cardiovascular imaging have allowed morphological and functional assessment of cardiac remodelling associated with systematic training, and consequently over the last decades a vast literature has been assembled focused on the constellation of alterations known as ‘athlete’s heart’. This chapter provides means for understanding the determinants, extent, and upper limits of cardiovascular adaptation in athletes. A detailed overview of all cardiac chambers is provided to help the physician to recognize the physiological limits of cardiovascular remodelling.