Echocardiography in non‐ischemic cardiomyopathies: differential diagnosis from athlete's heart

Regular exercise training induces several cardiac physiological adaptations commonly referred as “athlete's heart.” These changes can overlap pathological findings present in several cardiac diseases, mainly cardiomyopathies, associated with sudden cardiac death. The differentiation between physiological and pathological findings is often challenging and clinical decision making in such cases can be difficult: missing a condition associated with an increased risk of life‐threatening events has significant clinical impact, whereas the disqualification of a healthy athlete from competition can lead to severe psychological and socioeconomic burden. Echocardiography assumes a central role to evaluate cardiac remodeling in athletes. This paper provides an up‐to‐date and practical review of the role of echocardiography in differentiation non‐ischemic cardiomyopathies from “athlete's heart.”