The paper examines the current views of chronic overexertion of the cardiovascular system, emerging as a result of high intensity prolonged physical exercise. The major metabolic mechanisms that influence the occurrence of cardiac overexertion are discussed. The main interest of the work was focused on typical features of the clinical course, echocardiographic and echocardiographic manifestations of cardiac overexertion in athletes of different qualifications. The role of myocardial hypertrophy is demonstrated for increased incidence of sudden cardiac death of athletes, that necessitates regular medico-biological control of the cardiovascular system. To prevent the overexertion of the cardiovascular system in athletes, it is necessary above all to provide the rational organization of the training process, the reasonable use of extra-training tools for recovery and stimulation of performance, as well as the regular medical control, including the treatment of hidden pockets of chronic infection and functional studies of the heart, including ECG and echocardiography.