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Perform with Dr. Andy Galpin

Intense Exercise & Potential Heart Damage (aka Athlete's Heart)

1 tim 45 min13 maj 2026

In this episode, I cover "athlete's heart" — the paradox where the same cardiovascular adaptations that make endurance athletes exceptional can also mimic, and sometimes mask, real risk. I trace the history of what’s now known as exercise-induced cardiovascular remodeling (EICR), and walk through what's actually happening structurally, functionally, and electrically in a trained heart. I separate adaptive changes like left ventricular dilation and increased stroke volume from genuinely concerning issues such as hypertrophic cardiomyopathy, atrial fibrillation, coronary calcification, and myocardial fibrosis. I also answer the question, "is too much exercise bad for the heart?" This episode is for endurance athletes, lifters, coaches, along with anyone who might have a family history of heart disease.

Show notes: https://www.performpodcast.com/episodes/athletes-heart-intense-exercise-heart-damage

Sponsors

Momentous: https://livemomentous.com/perform

TrueMed: https://truemed.com/perform

Eight Sleep: https://eightsleep.com/perform

Chapters

(00:00:00) Introduction & the Athlete's Heart Paradox

(00:07:11) History of Athlete's Heart

(00:09:24) Heart Anatomy & Physiology Primer

(00:28:03) What Goes Wrong: Heart Attacks & Arrhythmias

(00:32:54) Genetic Causes: WPW, LDS & Hypertrophic Cardiomyopathy

(00:39:59) Exercise-Induced Cardiovascular Remodeling (EICR)

(00:53:12) Endurance vs. Strength Training Adaptations

(01:08:00) When Exercise Goes Too Far: AFib, Calcification & Fibrosis

(01:27:06) Screening, Testing & Interventions

(01:37:37) Summary

Disclaimer & Disclosures

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