Impact of endurance exercise on the heart of cyclists: A systematic review and meta-analysis

Aortic dissection during endurance cycling

An athletic man in his 40s was brought in to the emergency department by ambulance following a brief episode of central chest pain and dizziness five miles in to a ten mile stationary bike ride. Observations were normal at the scene and there were no ECG changes but he appeared unwell. Further assessment revealed no palpable right radial or brachial pulses and he complained of a severe right frontal headache. CT of the aorta showed an extensive type A dissection with a significantly dilated aortic root. Following emergency cardiothoracic surgery, he was found to have suffered cerebral hypoxia and died.

The athlete's heart: insights from echocardiography

The manifestations of the athlete's heart can create diagnostic challenges during an echocardiographic assessment. The classifications of the morphological and functional changes induced by sport participation are often beyond 'normal limits' making it imperative to identify any overlap between pathology and normal physiology. The phenotype of the athlete's heart is not exclusive to one chamber or function. Therefore, in this narrative review, we consider the effects of sporting discipline and training volume on the holistic athlete's heart, as well as demographic factors including ethnicity, body size, sex, and age.