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Oversized heart. Possibly athletes hearts. Any Cardiologist here or similar symptoms
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Hi Gang

Went in for x ray and discovered an oversized heart. Still getting to the bottom of it. but being in Taiwan with not as many sports focused cardiologist. Anyone on here with any insight in input? Will do some more tests this week but thoughts I can throw it out to the community for insight.

Anyone here have athletes heart? How does it affect your racing, etc

Thanks

Joshua
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Re: Oversized heart. Possibly athletes hearts. Any Cardiologist here or similar symptoms [culpritbicycles] [ In reply to ]
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Lots more information needed Joshua. DTOCE will chime in I am sure.
But, cardiomegaly discovered on a simple chest x-ray is not really going to tell you too much more. You need the results of other tests, particularly a transthoracic echo and ECG to figure out whether you actually do have anything going on or not.
No doubt those are the tests which are being ordered, when they are done there is certain information from them which will tell us more about whether anything is going on etc. This needs to be assessed on the background of any other medical issues, your age and other cardiac risk factors.
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Re: Oversized heart. Possibly athletes hearts. Any Cardiologist here or similar symptoms [culpritbicycles] [ In reply to ]
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As noted, cardiomegaly means that the heart looked enlarged on an x-ray. It may or may not actually be enlarged. You and your doctor will need to discuss your medical condition and a decision will be made about whether you need more testing or not. I'm not sure why the CXR was done and you don't need to tell me- your doctor knows and you should discuss it with him/her-especially with any specific symptoms of concern: chest pain/pressure, unusual shortness of breath, syncope/passing out. Sadly, it is common that testing often leads to more (costly) testing. When appropriate, it can pick up important pathology...

The most common cause of 'cardiomegaly' is that the CXR only made the heart appear bigger and often (~50% of the time) it was actually normal in size by a better test like an echo (cardiac ultrasound) or a chest CT scan.

An athlete's heart occurs in some people when years of training/exercising leads to dilation and some thickening of the heart as it adapts and becomes more efficient. I have one-my LV measures 6 cm on echo (clearly abnormally enlarged), with a resting HR of 47. No additional testing is needed for this condition, once found. It should not affect your racing, if you have one.

However, that does not preclude cardiac issues from arising. The dilation of the heart can lead to: afib (more frequent) or conduction issues requiring a pacemaker (far far less frequent) so it's always important to work with your doctor to have important symptoms checked out.



The echo also looks for much more serious conditions which can kill people like hypertrophic cardiomyopathy, valve disease of the heart or a dilated cardiomyopathy with weakening of the heart muscle.

Good luck.
Dale
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Re: Oversized heart. Possibly athletes hearts. Any Cardiologist here or similar symptoms [dtoce] [ In reply to ]
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dtoce wrote:
As noted, cardiomegaly means that the heart looked enlarged on an x-ray. It may or may not actually be enlarged. You and your doctor will need to discuss your medical condition and a decision will be made about whether you need more testing or not. I'm not sure why the CXR was done and you don't need to tell me- your doctor knows and you should discuss it with him/her-especially with any specific symptoms of concern: chest pain/pressure, unusual shortness of breath, syncope/passing out. Sadly, it is common that testing often leads to more (costly) testing. When appropriate, it can pick up important pathology...

The most common cause of 'cardiomegaly' is that the CXR only made the heart appear bigger and often (~50% of the time) it was actually normal in size by a better test like an echo (cardiac ultrasound) or a chest CT scan.

An athlete's heart occurs in some people when years of training/exercising leads to dilation and some thickening of the heart as it adapts and becomes more efficient. I have one-my LV measures 6 cm on echo (clearly abnormally enlarged), with a resting HR of 47. No additional testing is needed for this condition, once found. It should not affect your racing, if you have one.

However, that does not preclude cardiac issues from arising. The dilation of the heart can lead to: afib (more frequent) or conduction issues requiring a pacemaker (far far less frequent) so it's always important to work with your doctor to have important symptoms checked out.



The echo also looks for much more serious conditions which can kill people like hypertrophic cardiomyopathy, valve disease of the heart or a dilated cardiomyopathy with weakening of the heart muscle.

Good luck.
Dale

How many times have you self scanned your LV Dale?? I have an older GE Vivid machine at home and must admit to putting the probe on every few months to take a little peak......
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Re: Oversized heart. Possibly athletes hearts. Any Cardiologist here or similar symptoms [Amnesia] [ In reply to ]
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 Um...maybe a couple times...maybe more...🙄
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Re: Oversized heart. Possibly athletes hearts. Any Cardiologist here or similar symptoms [dtoce] [ In reply to ]
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dtoce wrote:
An athlete's heart occurs in some people when years of training/exercising leads to dilation and some thickening of the heart as it adapts and becomes more efficient. I have one-my LV measures 6 cm on echo (clearly abnormally enlarged), with a resting HR of 47. No additional testing is needed for this condition, once found. It should not affect your racing, if you have one.

Doc, I have a question...

Back in the day, the European country I'm from still had conscription and I was part of the last cohorts to be called up. During my medical check the doc took my pulse and said something like, "you have an athlete's heart eh", but didn't elaborate. So at that point I was 18 years old, and I had spend my high school years doing some windsurfing but definitely no serious endurance training. That remark always stuck with me though and when I picked up endurance sports in my 40s it turned out that (1) I'm pretty good at it (at least compared to other athletic pursuits I tried) and (2) my resting and max heart rates are pretty low.

So how does one end up with an "athlete's heard" without endurance training and is that a potential problem?

Citizen of the world, former drunkard. Resident Traumatic Brain Injury advocate.
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Re: Oversized heart. Possibly athletes hearts. Any Cardiologist here or similar symptoms [Richard Blaine] [ In reply to ]
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You, of course, wound have to ask your doctor what he meant as I cannot put words in his mouth.

That said, he likely meant that you had a low pulse, as is often seen in fit, endurance trained individuals. You are not ‘born’ with an athletes heart-it only occurs with exercise. Most of the studies I’ve read say ‘intensive endurance training’ but don’t define an exact timeframe. It is likely years-it was in my case as I have echo documentation over a decade.

Lifetime athletes often maintain low pulses. Not a problem unless too low or symptomatic.

I don’t even want to talk about max heart rates...

Discuss with your doctor now if concerned.
Last edited by: dtoce: Jun 25, 19 6:09
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Re: Oversized heart. Possibly athletes hearts. Any Cardiologist here or similar symptoms [dtoce] [ In reply to ]
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dtoce wrote:
Discuss with your doctor now if concerned.

Thanks! I'm not worried - I've been unfortunate enough to spend considerable time on the trauma ward with a gazillion doctors looking over me, most of whom went "that's hilarious - your resting HR is 43. We don't see many of your kind around here" and unhooking the alarm that goes off whenever your HR gets below 50.

Citizen of the world, former drunkard. Resident Traumatic Brain Injury advocate.
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Re: Oversized heart. Possibly athletes hearts. Any Cardiologist here or similar symptoms [Richard Blaine] [ In reply to ]
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I recently did a ECG, CT and what not more? Monitoring for 48 hours... Well my BPM drops in the night all the way down to 32. My average BPM of today is 44. A prof. specialized in athletes and rare heart conditions says I'm fine. However, pretty please go to a dr. to check it out.
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Re: Oversized heart. Possibly athletes hearts. Any Cardiologist here or similar symptoms [dtoce] [ In reply to ]
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Hi Dale

Got further testing.

Dr said its valve regurgitation with the following
mitral grade 2
tricuspid grade 2-3
pumonary grade 1.

Not quite sure what that means. He is a good cardiologist but specializes in kids so, he is not familiar with endurance athletes.

What do you advise? If I am a competitive AG racer in TW. how will this affect my training and racing?

Thanks

Joshua
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Re: Oversized heart. Possibly athletes hearts. Any Cardiologist here or similar symptoms [culpritbicycles] [ In reply to ]
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Hi Joshua, it would be best to send Dale a copy of your echocardiogram as just the grade of these valve lesions only provides a snippet of information, the echo has lots of other data which contribute to the overall picture and also requires integration with clinical history etc. There are a lot of things to consider, on the one hand if you can race as a competitive age grouper your cardiac reserve and function is likely to be excellent and none of those valvular lesions sound particularly sinister in terms of severely restricting your cardiac output, but whether they are "normal" or not for you requires a lot more information and may influence whether you need any particular monitoring or "treatment".

FYI-I am not a cardiologist like Dale but an anaesthesiologist with regular involvement in cardiac cases and peri-operative medicine.....


culpritbicycles wrote:
Hi Dale

Got further testing.

Dr said its valve regurgitation with the following
mitral grade 2
tricuspid grade 2-3
pumonary grade 1.

Not quite sure what that means. He is a good cardiologist but specializes in kids so, he is not familiar with endurance athletes.

What do you advise? If I am a competitive AG racer in TW. how will this affect my training and racing?

Thanks

Joshua
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Re: Oversized heart. Possibly athletes hearts. Any Cardiologist here or similar symptoms [culpritbicycles] [ In reply to ]
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You should, of course, discuss with the ordering doctor or consider a second opinion with an adult cardiologist.

That said, the test should have given a number regarding the LV size. If it is below the upper limit of normal, you do not have 'an enlarged heart' and the cardiomegaly was an overestimate on CXR. The finding of valve regurgitation is a often a normal finding. There are 4 valves in the heart and all often have a little bit of leak, like what you are describing. If any were 3+ or 4+, I'd tell you that you should definitely see a cardiologist.

I cannot advise anything-it's between you and your MD.
Sounds benign, though. FTR, I have 1-2+ MR and TR and 1+ PR...

*although we don't use the + system by echo here in the US (*it is used in the cath lab), we use 'mild' and 'mild to moderate'.
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