Mild Apical Hypertrophy

Hi I've experienced PVCs and runs of palpatations for over 27 years now with extensive tests regularly with the same conclusions.  Benign ectopics with a structually normal heart.  I had a motorbike accident when I was 19 with some chest trauma and a week or two later the ectopics started.  I'd never had them before this.  Over the years they have waxed and waned and changed severity, type and regularity.  Some years ago I went on Bisoprolol beta blocker to help but after about 18 months I came off them as I didnt want to take medication.  I have always exercised, mainly weight training since I was 23 and more recently I do running, boxercise, swimming and weights.  I think that I am very fit and I suffer no symptoms except for the palpatations.  My cardiologist has given me numurous tests over the years, even a TEE a few years ago.  Last year having had a bout of very frequent ectopics during exercise and post exercise I returned for the normal ecg, echo and exercise stess test.  The ecg and stress test came back normal and in fact I did very well on the exercise test.  But my cardio picked up from the echo that I have mild apical hypertrophy with an LVEDD of 5cm.  He was concerned about this and wanted me to have an MRI.  I cannot tolerate confined spaces so after half an hour of trying to have this test done eventually I could not go through with it.  My cardio is not in the slightest worried and just said that this could either be due to Athletes heart or scar tissue from the motorcycle accident and for me not to worry at all about it!!  

I am worried of course because my test results show some hypertrophy and from what I have read up it does seem to be something to be concerned about.  Do you think I should be unduly worrried or can this be just down to exercise?  Here are my results if this helps:

Thanks for your help and advice

Best regards

Richard

[Cleveland Clinic]

Apical hypertrophy usually isn't related to exercise, instead it's a form of hypertrophic cardiomyopathy that is very common in Japan.  We see it here infrequently.  It is associated with an abnormal ECG (yours according to what you stated above is normal).  More likely than not, the apical changes noted are potentially related to the car accident but that can't be proven.  I think the MRI would be very helpful in assessing the degree of hypertrophy and it's form.  I am a little concerned about this because you mentioned having some ectopic heart beats.  I think that this should be assessed further, at least with an MRI.  You should also probably see a hypertrophic cardiomyopathy specialist.  

[Dickyboy199]

Hi thanks for the reply but it was a motorcycle accident not a car accident and also I mentioned that I cannot tolerate a heart MRI having been in the tube for over half an hour in fear of confined spaces.  Here are the full echo results

-Mode/Cavity Measurements
Aortic Root 3.3cm    Left Atrium 4cm   LV End Diastole 5cm
IVS D 1.1cm
Doppler Study
Aortic Peak P Grad - 5mmHg
Pulmonary Peak P Grad - 7mmHg
Mitral Peak E 0.8 m/sec   Mitral Peak A 0.56 m/sec
Mitral E:A ratio 1.43
Chambers
Left Ventricle  Normal LV size.  Good LV systolic function
Mild Apical hypertrophy   Simpson EF=59%
Right Ventricle Normal RV size.  Good RV systolic function
Normal IVC size and preserved respiratory variations
Trabeculation:  Prominent RV apical trabeculations
Left Atrium - Normal
Right Atrium - Normal
Aortic Root - Normal
Valves
Aortic - Normal
Mitral - Slightly thickened mitral Valve leaflets with good mobility
          Trivial Mitral valve regurgitation
Pulmonary - Normal
Tricuspid - Normal Tricuspid valve appearance.  Trivial Tricuspid regurgitation
Thanks again Richard