Although there has been considerable elucidation of the athletic heart syndrome in Europe,1-4 this entity has not yet become universally recognized or accepted in the United States.5-9 The athletic heart may simulate the diseased heart by exhibiting a systolic murmur, a slow pulse rate, a variety of arrhythmias and disturbances of cardiac conduction, elevation of the S-T segments, and cardiac enlargement by x-ray. Despite the history of athletic endurance, many unfortunate athletes are classified as cardiac patients and are requested to stop athletic training. For the past five years, we have observed a superbly trained athlete with chronic cardiac changes. He has had a large globular heart, an intermittent systolic ejection murmur, sinus bradycardia and arrhythmia, a wandering atrial pacemaker, occasional nodal premature beats, elevation of the S-T segments, broad peaked T waves, and the ability to meet the severe physical demands of training and competitive rowing at