Reviewing some special studies from junior elite and professional adult tennis players, it is concluded that tennis is a sport with high demands on volume overload and moderate demands on strength. This results in physiologic cardiac adaptation with high normal values for LV wall dimensions, cavity size and mass index. There is also volume overload of the atria resulting in enlargement. One of the studies was retrospective and female athletes were not included. The cardiac adaptation of eccentric LV hypertrophy in most players is probably manifested after a few years of strenuous exertion in tennis and probably also due to other training regiments needed to perform tennis on elite level. The classification of tennis should be reconsidered once more evidence is available.
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