Matters of the athletic heart.

Frequently an underwriter or medical director will question whether an increase in left ventricular mass represents pathologic left ventricular hypertrophy (LVH) or physiologic changes related to exercise. The LVH condition reflects end-organ damage related to abnormal hemodynamic stresses and confers an increased morbidity and mortality risk. When left ventricular mass is increased because of exercise, measured changes represent a normal, healthy cardiovascular system responding to the demands of that exercise. This article summarizes medical findings that distinguish pathologic LVH from an "athletic heart."