Echocardiography in Athletes

Two-dimensional echocardiography and colour Doppler echocardiography are the most widely used imaging methods in athletes. In these subjects, echocardiography is a valuable way to diagnose potentially lethal heart diseases. In fact, in the last few years there has been a great deal of media coverage of episodes of sudden death associated with physical exercise among competitive athletes. Often the underlying cause of sudden death in such patients involves structural changes to the heart and/or blood vessels that may be identified by echocardiography. The existence of heart disease may be an exclusion criterion in competitive sport in order to reduce the risk of sudden death and/or it may justify the introduction of an automatic defibrillator. On the other hand, athletes’ hearts, particularly those of well-trained athletes who practise endurance sports (marathons, swimming) or mixed sports (cross-country skiing, cycling, rowing), encounter structural and functional changes that must be identified so that heart disease is not diagnosed incorrectly. The aim of this chapter is to provide a structured guide to studying cardiac echocardiography in athletes.