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Athlete’s heart: When high-intensity workouts thicken your heart muscles

Athlete’s heart: When high-intensity workouts thicken your heart muscles

While thickening of heart muscles is generally considered benign, it can lead to serious complications in people with undiagnosed heart conditions
Athlete's heart, which refers to thickening of heart muscles, is usually found in sportspersons and athletes who have a rigorous workout and weight training regimen
Photo by Anantha Subramanyam K/Happiest Health

High-intensity workouts can cause thickening of the heart muscles, especially in sportspersons and those who regularly lift weights in the gym. Experts point out that this condition is medically termed as athlete’s heart. It is the natural adaptation of the cardiac muscles to meet the physical demands of intense exercise and training. The heart becomes slightly enlarged with thicker muscles compared to that of a regular individual. Though athlete’s heart is considered as a benign condition in highly trained athletes, it could manifest as a serious problem in those athletes who have undiagnosed underlying conditions.

Hypertrophic cardiomyopathy is a genetic condition where cardiac muscles thicken, leading to variations in heart rate. This puts the individual at a higher risk of developing sudden cardiac arrest,” says Dr Jay Shah, senior interventional cardiologist, HCG Hospital, Ahmedabad. He adds that overexertion could lead to further thickening of heart muscles in such individuals.

What causes athlete’s heart?

Dr Rana Sarabjit Singh, consultant, cardiology, Manipal Hospital, Kolkata, explains that for a person who’s into intense training or exercise, their heart must work more than a normal individual (as it needs to pump more) to supply oxygenated blood across the body. This eventually leads to the thickening of the cardiac muscles.

Even though it is a normal condition, Dr Shah explains that athletes’ heart is something that is developed gradually, leading to sudden morphological changes in the heart. This can have harmful effects. While contraction of the heart muscles remains normal, the relaxation gets affected. This leads to variation in heart rate and a high risk of arrhythmia, bradycardia and other heart complications, which if left untreated could lead to heart failure.

How overexertion affects your heart

Overexertion can also lead to something dangerous if your heart is not prepared to handle it. “Excessive physical exertion can lead to sudden rupture of plaques (cholesterol deposition in the arteries of the heart),” says Dr Shah. He adds that the heart cannot handle this kind of exertion. It is dangerous, especially in people whose lipid and cholesterol levels are not being checked regularly.

“Intense exercise increases the risk of cardiac arrest, arrhythmias and heart attack due to plaque rupture,” says Dr Sanjay Bhat, Sr consultant, interventional cardiology, Aster CMI Hospital, Bengaluru.

Undiagnosed heart conditions are the main reason for sudden cardiac arrests in athletes and sportspersons. However, such conditions often get wrongfully attributed to athlete’s heart, and some people indulging in high-intensity training often dismiss symptoms of underlying heart conditions and irregular heart rate as athlete’s heart and delay treatment.

It is one of the reasons why there has been a long-standing debate among cardiac experts, including the American Heart Association (AHA) to conduct regular screening of athletes and sportspersons for any heart condition. It has been pointed out that an increase in cardiac mass due to thickening of the cardiac muscles (caused by intense training) might lead to serious heart complications.

Basic precautions for athletes

Some of the common precautions listed by Dr Bhat for sportspersons and those into high-intensity interval training (HIIT) include:

  • A balanced healthy diet with lots of fruits and vegetables
  • Quitting smoking
  • Not using steroids for performance enhancement
  • Avoiding recreational drugs
  • Avoiding alcohol consumption
  • Staying hydrated while exercising
  • Having a proper warm up session before workouts

Dr Singh explains that being athletic itself is a way of keeping the heart healthy. However, people with extreme stress, shortness of breath, family history of heart conditions or lethargy should undergo periodic testing to rule out anything out of the ordinary. If the tests don’t reveal anything abnormal, they can continue with their physical activity.

Dr Shah says that those with a family history of heart conditions should get themselves checked before indulging in high-intensity workouts.

“Those with genetic conditions might be at higher risk of suffering sudden cardiac arrests after high-intensity exercise. So, that has to be ruled out,” he adds.

Dr Singh points out that though exercise is crucial for ensuring your health, one should know their endurance limits and not try to overstrain themselves, as it can put immense pressure on the heart.


  • Athlete’s heart is a cardiac condition usually found in sportspersons and athletes who have a rigorous workout and weight training regimen.
  • The cardiac muscles of these people become thick, as they have to work harder to pump oxygenated blood across the body due to excess physical exertion.
  • While it is generally considered a benign condition in athletes, it can lead to serious cardiac complications (including cardiac arrest) in people with undiagnosed heart conditions.

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