Abstract Background Controversy surrounds the cardiac effects of competitive sports and the athlete’s heart. In this review, we present and discuss the main cardiological findings in competitive athletes. Method Selective review of pertinent literature retrieved by a search with the keywords “athlete’s heart,” “ECG,” “echocardiography,” “endurance exercise,” “longevity,” and others. Results Regular exercise leads to functional and structural adaptations that improve cardiac function. Athlete’s heart, which develops rarely, is a typical finding in endurance athletes. This condition is characterized by physiological, harmonically eccentric hypertrophy of all cardiac chambers. The athlete’s ECG can be used to distinguish physiological, training-related changes from pathological training-unrelated changes. The athlete’s heart function is normal at rest and increases appropriately during exercise. The cardiac markers troponin and B-type natriuretic peptide are within the normal range in healthy athletes at rest, but can temporarily be mildly elevated after exhausting endurance-exercise, without evidence of myocardial damage. The epidemiological data suggest that participation in competitive sports increases life expectancy. Conclusion Competitive exercise does not induce cardiac damage in individuals with healthy hearts, but does induce physiological functional and structural cardiac adaptations which have positive effects on life expectancy. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3561756/
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