title: Cardiac fibrosis in the elderly, normotensive athlete: case report and review of the literature.
abstract: BACKGROUND
  Cardiac fibrosis occurs with normal aging, but the extent of this process and its effect on cardiac function is unknown. Fibrosis in the nonhypertensive elderly patient is thought to be due to decreased degradation, and not increased deposition, of collagen. The cause of this decreased degradation is unknown. Athletes commonly develop cardiac hypertrophy, and recent evidence has linked long-term physical activity to the development of interstitial myocardial fibrosis. Whether this exercise-induced fibrosis occurs regularly, or only in genetically predisposed individuals, is unknown.
  
  
  METHODS
  We present the case of an elderly, nonhypertensive athlete who died suddenly of sepsis. Autopsy demonstrated foci of fibrosis throughout the right and left ventricle and significant narrowing of the left ventricular cavity. The findings may be secondary to aging, athletic activity or an undiagnosed medical condition.
  
  
  CONCLUSIONS
  The true incidence and importance of age- and exercise-associated myocardial fibrosis is an area for future research.
authors: Global Neuroscience Initiative Foundation, Los Angeles, CA, USA. slakhan@gnif.org
authors: Shaheen E
authors: SE
authors: Lakhan
authors: Lindsey
authors: L
authors: Harle