Questions posted in the Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: 34 yr old male runner - Bradycardia and Left Ventricular Hypertrophy

Forum: The Heart Forum
Topic: Bradycardia

Posted by Alan on July 21, 1999 at 11:28:01

I am a 34 year old male. Recently, upon exiting a hot tub (my first hot tub experience), I became dizzy and fainted. After being examined by my family doctor, I underwent a some blood work and had an ECG. The blood work (including thyroid) all came out good but the ECG indicated Sinus Bradycardia (resting heart rate in low 40’s) and Left Ventricular Hypertrophy. My suspicions for the last 10 years or so were also confirmed - that I have low blood pressure (I get brief headaches and momentary dizziness from bending forward to tie my shoe laces or coming out of a hot bath).

As I wait for subsequent examinations, I know that some level of these conditions can be common in athletes. Although I have been running for just over two years averaging 30 miles per week, I certainly do not consider my overly athletic, either in performance or physique. I am wondering if it this combination of conditions is truly common given my level of athleticism, and more importantly, is it reasonable that I continue to run? Is this something I really need to be woried about?


Posted by CCF CARDIO MD - CRC on July 21, 1999 at 12:53:35

Dear Alan,

Your's is an interesting but not so uncommon case. Let's start with the low heart rate and ventricular hypertrophy. These are both normal physiological responses to increased exercise and are dose dependent. Thus the greater the intensity and duration of exercise the lower the heart rate and the more the hypertrophy. I agree that you do not qualify for Olympic status athlete but you are certainly not a couce potato (or potatoe for some). The low heart rate is due to increased vagal tone which bring us to the fainting. Athletes have a greater propensity to faint to start. A hot tub is the perfect stressor to maximize this potential by vasodilating all the blood vessels. Add a little alcohol (or pregnancy) stand up rapidly and presto you have the common faint. All that being said it is possible there are some underlying medical conditions contributing to your condition. One potential way to test this theory is to stop exercising for about 3-6 months and see if the heart rate increases and the hyertrophy decreases. Your doctor will have to work through this with you and you may need to see a specialist in autonomic function. (can probably be found at a University hospital).

I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

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