I'm not a cardiologist.

I'm 55 and have been been pretty serious about endurance sports since early HS. I also have to get EKG's every 2yrs because requirements to hold a car racing license. I had to jump thru some hoops re. EKG because my heart apparently shows the effects of years of endurance training. Those affects are visible in the electrical traces of the EKG. This initially caused some alarm for my GP so she sent me to a cardiologist. Once I explained the endurance sports history, he took a look at my EKG and shrugged it off.

Left ventricle apparently supplies blood to skeletal muscles. Right ventricle provides blood to other stuff like lungs. Left can work harder w/o much effort because all those arteries can take on more blood w/o much pressure increase. Right ventrical tho, when it works harder in tandem, pushes against increased BP because the arteries it provides can't absorb the volume increase so easily.

So right ventricle reacts in non-standard ways, not all of them maybe generally perceived as entirely positive ways.

Google right ventricle hypertrophy endurance and you'll find lots of articles.

As I understand it, it's all good unless there are signs of it being not good. That is to say...don't worry about the ventricle being big, worry only if it starts doing things it's not supposed to do, or the converse. The fact that it's big, with a history of endurance sports, in isolation is not cause for alarm.

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Did your doc raise the possibility of pulmonary hypertension? Your RV pushes blood into the pulmonary system, and any number of things can cause dilation, but very often it's because of downstream resistance, either as a result of a bad pulmonic valve, a pulmonary embolism, or pulmonary hypertension (either primary or secondary). Your echo would have demonstrated a valvular problem, and the lack of acuity points away from pulmonary embolism, shunt, and other obvious cardiac abnormalities. It should pick up PH as well, but sometimes things get overlooked, unfortunately.

I don't know of RV dilation resulting from endurance training, specifically, but I suppose it's possible, if unlikely.

I would ask about PH if he or she didn't address it already.

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Do you have any shortness of breath or decrease in exercise capacity?

Isolated RV dilatation usually is due to downstream increased pressure. The most common cause is increase pressure coming from the left side of the heart (it is all a circuit) but that doesn't seem to be the case with you given your echocardiogram results. The fact that your RV has normal wall thickness suggests that you have not had a chronic and/or substantial right sided pressure problem.

Pulmonary emboli can cause that finding but usually there are obvious symptoms to point you toward this, e.g. the RV finding isn't an incidental finding. Rarely, one can have chronic and insidious blood clots that go unnoticed and lead to chronic elevations in pulmonary pressures.

I think starting with a sleep study to screen for sleep apnea (a common cause of this echo finding) is a good place to start. If this is positive then you would need a CPAP machine. I would then repeat the echo in a few months to see if it has resolved. It usually does if it is due to untreated sleep apnea. If this is negative then I would repeat the echo over the short-term.

If a repeat study shows you still have dilatation then I would work it up further with a person that specializes in pulmonary hypertension which include both pulmonary and cardiology physicians.

Hope that helps.

Dont know about the dilation, but it is normal to have PVC's for athletes. My doc says 100 to 200 a day is no problem, Even a few more would not warrant anything drastic. Dont know how many you were/are having, but I have found that a lot of outside things can affect electrical activity in your heart.

Cutting the booze and stimulants is a great start, get some blood work and pay attention to minerals, especially magnesium and sodium and potassium. Could be you are just deficient in one or more of those and it is an easy fix. A lot of docs overlook this simple but often the case solution with athletes.

Stress, sleep deprivation, workout loads, and a few other things can also be big factors. Take a good look at your lifestyle and see if you are big in any of these categories. What happens a lot of times is when you start to mitigate some of these things, your rhythm gets better. If you see progress then you are heading the right direction.

When I had my episode it was super low magnesium/sodium, lack of sleep, and a ocean swim race in the middle of this. Along with the usual life stresses, 3 to 5 cups of coffee, and drinking a couple drinks 3 or 4 times a week. The race was the straw that broke the camels back so to speak, but when reflecting on the whole episode with some distance and history, all those other things threw in their lots too..

And now way to really know which one or how many had I not been doing and nothing would have happened. But when you race and train like I did, there are just 1000's of opportunities to have a full basket of bad things and then the trigger that fires it off.

Stress echo would be good, I get one every year now for the past 16 years. I also did my first calc test last year to add to my information. If any turn negative then I will go to the next level, but until then I just mitigate all the stuff that goes into that nasty basket..

I am not a cardiologist but worked in echocardiography for about 20years. My first question, and I realize everyone thinks their doctor is the best, but how are they coming up with RV dilation? Is this via mmode from parasternal long and /or short axis? Or taken from the newer method from the apical four chamber? 3D is notoriously unreliable due to the shape of the RV so I will assume it’s not that. For some of the things others have mentioned I would expect atrial enlargement (right and or left).


For the most part mild RV enlargement on echo In a active younger person is nothing significant.