[The sports heart and its differentiation. Differential diagnosis of pathologic conditions in athletes].

A uniformly enlarged heart with increased performance is known as athlete's heart. The largest hearts are seen among endurance-trained athletes. The ratio mass to volume remains unchanged, both in endurance-trained and power-trained athletes, and a concentric type of hypertrophy is not induced by power training. Echocardiographic changes in the left ventricle are only slight. Such a heart is less common among athletes than is generally supposed. For differentiating between physiological and pathological hypertrophy, the history of sporting activity is of major importance, and can be defined by means of a score. The interruption or cessation of physical training results in regression of dilatation and hypertrophy. In non-competitive athletes cardiac enlargement must be considered pathological until proved otherwise.