Athlete's Heart Syndrome

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    May 31, 2012 12:24 PM GMT
    Does anyone have any experience with "Athlete's Heart Syndrome"? My GP scared the heck out of me. First she said my EKG was "abnormal," and she was concerned . . . then she wanted me to do an ultrasound.

    I know a cardiologist, and I had him look at my EKG, and he said that my EKG was typical for an endurance runner.

    http://en.wikipedia.org/wiki/Athletic_heart_syndrome

    Has anyone else been "diagnosed" with this? (Is it even considered a diagnosis if the syndrome is not a pathology?) If so, what did your doctor say? Were or are you concerned about it?

    Thanks for your thoughts.
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    May 31, 2012 1:55 PM GMT
    RunnerBen saidDoes anyone have any experience with "Athlete's Heart Syndrome"? My GP scared the heck out of me. First she said my EKG was "abnormal," and she was concerned . . . then she wanted me to do an ultrasound.

    I know a cardiologist, and I had him look at my EKG, and he said that my EKG was typical for an endurance runner.

    http://en.wikipedia.org/wiki/Athletic_heart_syndrome

    Has anyone else been "diagnosed" with this? (Is it even considered a diagnosis if the syndrome is not a pathology?) If so, what did your doctor say? Were or are you concerned about it?

    Thanks for your thoughts.


    Yes. Last year I went in to get a full physical and it turns out my heart rate dropped below 40 during the physical, and this freaked out the doctor so he sent me to a cardiologist.

    He performed an echocardiogram and told me it seems that there was some extra thickness. Pretty scary. He ended up doing a transesophageal echocardiogram (not fun.. they dose you and put a camera down a tube in your throat to get a closer look) and in the end he said that the heart seems strong and he does not see any cause for concern; that it may be an adaptation to extreme and prolonged exercise. He suggested a follow-up around every six months to monitor the heart.

    If the cardiologist said not to worry, I would not worry about it, unless you experience other symptoms aside from low HR (bradycardia).

    What caused you to go in, in the first place? Was it a routine physical?
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    May 31, 2012 2:53 PM GMT
    Just a routine physical. My heart rate was 46, so they decided to perform an EKG, and my doctor became nervous.

    They didn't tell me to come back every six months, though. Even if they do, I'm not sure I'd comply. Sometimes I wonder how much of medicine is about a doctor covering him/herself from legal liability, as opposed to doing what's needed, and no more.
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    May 31, 2012 3:11 PM GMT
    RunnerBen saidJust a routine physical. My heart rate was 46, so they decided to perform an EKG, and my doctor became nervous.

    They didn't tell me to come back every six months, though. Even if they do, I'm not sure I'd comply. Sometimes I wonder how much of medicine is about a doctor covering him/herself from legal liability, as opposed to doing what's needed, and no more.


    Yeah. I went back for a follow-up after 6 months, and all he did was take my vitals and ask about any changes in symptoms/conditions. I was out in 15 minutes.

    I totally felt like I wasted my copay. I probably won't schedule another follow-up unless I experience health problems. You're probably right, that it's a question of liability.. but also more appointments = $.
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    May 31, 2012 4:59 PM GMT
    Had a cardiologist mention they get a rugby/Lacross player every once in a while with alarmingly low heart rates.

    But, I love proactive GPs.
  • Medjai

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    May 31, 2012 5:04 PM GMT
    I've been diagnosed with bradycardia, beyond what an average athlete should have. A resting heart rate of 42 is apparently a concern. And if you tie that together with ventricular hypertrophy (an enlarged Left ventrical), you get a recipe for sudden cardiac death. This situation is unique to athletes too.

    Looks like working out can actually kill you. icon_confused.gif

    It doesn't help that I've had an episode where my heart rate dropped low enough that I passed out either... Apparently it's not normal.
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    May 31, 2012 5:58 PM GMT
    When I used to do century rides, my average resting heart rate was around 50.

    It was always fun to get a physical and have to explain to them that I'm not dying - I'm just REALLY relaxed. icon_lol.gif
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    May 31, 2012 7:13 PM GMT
    Not sure what they called it .... but they said i had an enlarged heart... low pulse... and a heart valve that was a little deteriorated. My doctor at the time told me to take l'arginine, l'orthinine and l'lysine every night for the valve and a few other things for overall health. that was 30 years ago... went to another specialist 5 years ago couldn't find anything wrong. So i guess i'm ok...lol. A lot of things can be reversed. So, if he says don't worry about it.... it means right now and you're probably on the right track. Check every thing out.
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    May 31, 2012 7:36 PM GMT
    A heart rate of 40-60 BPM has always been normal for me, even when I was an obese couch potato. It seems to run in my family, but it doesn't have any heart trouble associated with it. My heartbeat has always been regular.
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    May 31, 2012 7:57 PM GMT
    DudeInNOVA saidA heart rate of 40-60 BPM has always been normal for me, even when I was an obese couch potato. It seems to run in my family, but it doesn't have any heart trouble associated with it. My heartbeat has always been regular.


    A drug called Metropolol, a beta blocker enabled me to have 120/80 with 60 pulse at 270lbs. All sorts of side effects, like being unable to maintain an erection...icon_rolleyes.gif
  • real_diver2

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    May 31, 2012 8:01 PM GMT
    It's called "left ventricular hypertrophy" and your cardiologist friend is correct. No big deal for someone who is physically active.

    My EKG has shown that for years. Both my doctor and cardiologist have commented that it is normal for me (ran 5 mi/day for 27 years, now do weights and cardio in the gym 7 days/wk).

    It just means that the left ventrical muscle is thicker and more powerful (in your case). The only time you worry is if you have something like heart failure or heart disease...and I doubt that is the case.

    Relax.

    So far as heart rate, mine can be anywhere between 48 and 60. Again...you exercise and your heart rate drops. My BP is 110/70.
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    Jun 01, 2012 1:21 AM GMT
    Wasn't that how strongman Jesse Marunde passed away?
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    Jun 01, 2012 2:16 AM GMT
    I've been diagnosed with bradycardia as well.. resting HR is 49..
    My cardiologist is unconcerned. UNLESS I have sudden BP drops when standing.

    Never had em.. not gonna worry!
    And my uber healthy heart is reversing the stress related Atherosclerosis!
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    Jun 01, 2012 2:24 AM GMT
    when riding my bike everyday i would feel really dizzy standing up from a seated position. went to the doctor, they did a ecg and they told me that one of my valves only closed 99% of the way but it was nothing to worry about and my heart rate was around 50 bpm. im not dead yet so i think its ok.
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    Jun 01, 2012 2:25 AM GMT
    My blood pressure is low too. It think it's usually < 100/60. Again, this seems to be genetic and nothing to worry about.
  • Medjai

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    Jun 01, 2012 5:48 PM GMT
    real_diver2 saidIt's called "left ventricular hypertrophy" and your cardiologist friend is correct. No big deal for someone who is physically active.

    My EKG has shown that for years. Both my doctor and cardiologist have commented that it is normal for me (ran 5 mi/day for 27 years, now do weights and cardio in the gym 7 days/wk).

    It just means that the left ventrical muscle is thicker and more powerful (in your case). The only time you worry is if you have something like heart failure or heart disease...and I doubt that is the case.

    Relax.

    So far as heart rate, mine can be anywhere between 48 and 60. Again...you exercise and your heart rate drops. My BP is 110/70.


    Just a heads up, left ventricular hypertrophy coupled with bradycardia can lead to sudden cardiac death. It's when for no apparent reason, the heart just stops. It's why you have high school athletes just randomly dropping on the middle of games, and why every school with a sports program is required to have an AED. So not quite nothing...
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    Jun 03, 2012 11:10 AM GMT
    Low resting heart rates aren't a concern generally. Lance Armstrong's resting heart rate is in the 30s. For athletes, it merely reflects higher resting vagal tone, the body and heart is more efficient, and it doesn't have to beat more frequently to get the blood to the body at rest.

    LVH is different from hypertrophic cardiomyopathy (HCM). HCM is what is dangerous and is usually a genetic/inherited condition. LVH is seen in athletes at times, often because the heart is a muscle, and if it's working (just like lifting at the gym), it may get bigger slightly.

    An echo should be able to differentiate between the two, but if it is tough to tell whether it's athletic heart vs HCM, what can be done is to recommend much less exercise for 6-8 weeks and to see if the heart muscle hypertrophy lessens (like not lifting for several weeks will make the muscles get smaller). If the heart muscle doesn't decrease in size, then HCM is higher on the differential.

    Yep, athletes like Reggie Lewis and Ryan Shay had HCM and died suddenly. They didn't just have athletic heart.
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    Jun 03, 2012 11:15 AM GMT
    RobertF64 saidHad a cardiologist mention they get a rugby/Lacross player every once in a while with alarmingly low heart rates.

    But, I love proactive GPs.
    Same here. My RHR is in the 50s and the doc ran me through an ultrasound this spring to check and see if anything might be going on. It set me back a few bills, but I was happy to find out that structurally things are just fine.