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Hypertrophy, or the enlargement of the heart, can be induced in two forms. A physiological hypertrophy occurs when the heart becomes stronger and can handle increased blood volume and pressure loads because of an increase in muscular strength. An athlete's heart follows the pathways for physiological hypertrophy. A pathological hypertrophy occurs when the heart enlarges to try and compensate for the higher blood volume and pressure loads, but ultimately appears to be maladaptive. Pregnancy has multiple effects on many different systems within the body, one of them being cardiac function. During pregnancy, a female’s heart enlarges in order to adjust to the increase in blood volume from the growing fetus. In most pregnant women, this appears to be beneficial, but for some women, a pathologic state of peripartum cardiomyopathy ensues. One factor that seems to distinguish pathologic from physiologic hypertrophy is the time course of the stress; physiologic hypertrophy results from transient stresses such as exercise bouts followed by rest or pregnancy followed by delivery while continued stresses such as prolonged hypertension bring about pathologic hypertrophy.
Wagner, Marcus J., "The Effects of Multiple Pregnancies on the Murine Heart: Are Changes in Pregnancy-Induced Cardiac Function Exacerbated After Multiple Pregnancies?" (2016). Biology Summer Fellows. Paper 24.