ACL Graft Choice Risk Factors ACL-RSI Calculator (Return to Sport Readiness)AHA Pre-Participation Screening AOFAS Ankle-Hindfoot Scale ASES Elbow Score ASES Shoulder Score Acute:Chronic Workload Ratio (ACWR)Altitude Gain Guidelines Ankle Syndesmosis (High Ankle Sprain)Athlete's Heart vs HCM Beighton Score (Joint Hypermobility)Borg CR-10 Scale Borg RPE Scale (6–20)Brighton Criteria (BJHS)Buffalo Concussion Treadmill Test (BCTT)Child SCAT6 (Age 8–12)Commotio Cordis Protocol Cumberland Ankle Instability Tool (CAIT)DASH (UE Disability Index)Doha Groin Agreement ESC HCM SCD Risk Score ESC Pre-Participation Screening Energy Availability Calculator FAI Syndrome (Warwick)FAOS (Foot and Ankle Outcome Score)Fear-Avoidance Beliefs Questionnaire (FABQ)Female Athlete Triad Risk Foot Posture Index (FPI-6)Foot and Ankle Ability Measure (FAAM)Functional Movement Screen (FMS)Graduated Return-to-Play (GRTP) Protocol HAGOS (Hip and Groin Outcome Score)Hamstring Asymmetry Index Heat Index (Apparent Temp)Hip Outcome Score (HOS)Hooper Index (Athlete Wellness)I-PRRS (Psychological Readiness)IKDC (Objective Examination)IKDC (Subjective Knee Evaluation)Injury Severity KJOC Shoulder & Elbow Score KOOS (Knee Outcome Score)KOOS-PS (Physical Function Short Form)Kujala (Anterior Knee Pain Scale)LEAF-Q (LEA Screening)Lake Louise AMS Score Limb Symmetry Index (LSI)Little League Elbow Grading Lysholm Knee Score Marx Activity Rating Scale (MARS)Mayo Elbow Performance Score (MEPS)Modified Schober Test NEXUS C-Spine Criteria Neck Disability Index (NDI)One-Rep Max Estimator Osgood-Schlatter Severity Oswestry Disability Index (ODI)Ottawa Knee Rules Oxford Elbow Score Oxford Shoulder Score PAR-Q+ Readiness Questionnaire PARS-3 Youth Readiness Patellar Instability Severity Score Pitch Smart Guidelines (USA Baseball)Pittsburgh Knee Rules Post-Concussion Symptom Scale (PCSS)QuickDASH (Shoulder & UE)RED-S CAT (Clinical Assessment)Re-injury Anxiety Inventory (RIAI)Relative Age Effect (RAE)Return-to-Play Battery SANE Score (Single Assessment)SCAT6 (Sport Concussion Assessment Tool 6)SCOAT6 (Sub-acute and Office Follow-up)SEAQ-I Appetite Questionnaire STarT Back Screening Tool Session RPE (Internal Load)Sever's Disease Activity Single-Leg Hop Test Battery Standardized Assessment of Concussion (SAC)Steroid Equivalence Calculator Stinger / Burner Grading Sweat Rate and Rehydration TSK-11 (Tampa Scale for Kinesiophobia)TUE Criteria Checklist Tanner Stage Assessment Tegner Activity Scale (TAS)Training Monotony and Strain UCL Injury Risk (Medial Elbow)VISA-A (Achilles Tendinopathy)VISA-P Scale (Patellar Tendinopathy)VO2 Max VOMS (Vestibular/Ocular-Motor Screening)WADA Prohibited List Checker WBGT (Wet Bulb Globe Temp)WORC (Rotator Cuff Index)WOSI (Shoulder Instability Index)Wilks Score (Relative Strength)Wind Chill Index hEDS Diagnostic Criteria (2017)iHOT-33 (International Hip Outcome Tool)

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Athlete's Heart vs HCM

Athlete's Heart vs HCM — Maron/Pelliccia Algorithm

HCM Score

Athlete's Heart Score

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HCM Likelihood

Select Clinical Features Present

The gold standard for HCM vs Athlete's Heart differentiation in the grey zone (13–15 mm) is Cardiac MRI with Late Gadolinium Enhancement (LGE). LGE = fibrosis = HCM.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Pre-participation cardiovascular screening of competitive athletes aged 12-35 years, especially in sports with high static/dynamic demands (e.g., basketball, soccer, rowing).

Evaluation of athletes presenting with exertional syncope, near-syncope, chest pain, palpitations, or unexplained dyspnea.

Differentiation between physiological left ventricular hypertrophy (athlete's heart) and pathological hypertrophic cardiomyopathy (HCM) in athletes with borderline ECG or echocardiographic findings.

Follow-up surveillance in athletes with known HCM or family history of HCM to guide exercise recommendations and risk stratification.

Assessment of athletes with abnormal ECG patterns suggestive of HCM (e.g., deep T-wave inversions, pathological Q waves, left ventricular hypertrophy with strain).

Key Indication - Differentiating Athlete's Heart from HCM

The primary utility of the Athlete Heart HCM tool is to distinguish physiological cardiac adaptations from pathological HCM. Key discriminators include left ventricular wall thickness (LVWT) >15 mm (suggestive of HCM), left ventricular end-diastolic diameter (LVEDD) >55 mm (more common in athlete's heart), and diastolic function parameters (e.g., E/e' ratio). The 2014 ESC guidelines recommend using a multiparametric approach including ECG, echocardiography, and cardiac MRI when LVWT is 13-15 mm. The tool integrates these parameters to provide a probability score for HCM.

When Not to Use / Contraindications

Do not use as a standalone diagnostic tool for HCM; definitive diagnosis requires genetic testing, cardiac MRI with late gadolinium enhancement, and/or endomyocardial biopsy.

Not validated in athletes >35 years old or in those with known coronary artery disease, hypertension, or aortic stenosis that can cause secondary LV hypertrophy.

Avoid in athletes with poor echocardiographic windows (e.g., severe obesity, lung disease) as image quality may compromise measurements.

Not applicable for screening of other cardiomyopathies (e.g., arrhythmogenic right ventricular cardiomyopathy, dilated cardiomyopathy).

Do not use in symptomatic athletes with acute cardiac decompensation (e.g., acute heart failure, sustained ventricular arrhythmia) without prior stabilization.

Last Comprehensive Review: 2026