Weight Lifter has heart problems

I have lifted weights 4 days a week for 17 years.  I have in the past taken steriods but am currently not.  I went to a doctor for a routine visit this week and my blood pressure was high for the second time in 2 months, so the dr. did EKG and few other in office tests (this is an internist, not heart doctor).  He said that there was an abundance of fluid on my heart and that I was not far off from stroking.  I had noticed in the past 6 months extreme shortness of breath and fatigue after my morning workouts.  I would not have energy for the rest of the day after the workout.  The doctor is sending me to have more tests done.  I am currently working as a personal trainer and am worried that I will not be able to continue my weight lifting to stay in tip top shape.  The dr. put me on Avalide and I guess I just need to know, if I go to the gym and lift 300lbs on the bench, am I going to have a stroke?  Heart attack?  Am I crazy for continuing my regular weight lifting routine?  
Confused and Worried!

[3dragons]

I really feel for you right at the moment! I have been a group fitness instructor for 16 years, with Fitness Figure competing in amongst those years as well, and a spell of PT. Most of my hobbies were also active, including motorcycle racing.

Due to a diagnosis of dilated cardiomyopathy earlier this year - well, less the diagnosis and more because of the symptoms! - my life has had to radically change.

I am emotionally struggling with this sudden radical lifestyle change, and feel quite angry because I have always lived in a way to be in optimum form and good health.

Sounds like you have been very wise in getting your symptoms investigated. I am interested to hear how things progress for you, and I hope it is good news;  If not, be safe in the knowledge that every bit of discipline that you have applied over the past 17 years to your training, the mindset to succeed, can be re-routed to living as well as you can with whatever you have.


Its easier said than done, and after 8mths of trying I am still really struggling. However, I am still breathing so there is still 'fight' left in me! If you have to step in the ring and do a few rounds, I'll fight with you!!

[KG75]

KMoore--I don't know anything about this stuff but "Not far off from stroking" does not sound good at all. What did the doctor say caused this---did he really think steroids taken long ago had? Or is there something about power-lifting?

3dragons---what were the symptoms of dilated cardiomyopathy---was it extreme pain or just a kind of squeezing and pressure, or what?

I've recently experienced chest pains (for the moment more squeezing and pressure, to be honest) for the first time (I'm 33). I played college hockey and have remained very active since, though sometimes in spurts, which may not be good. I typically push myself in workouts as far as I can go. I drink a lot of coffee and I'm a heavy social drinker--but still, everything I see online indicates that I don't have a single one of the risk factors, and I've never had high blood pressure. (I'm seeing a doctor next week.) But I'm beginning to wonder if there's not something about hyper-competitive sports and high-level cardiovascular training that might just be bad for us at a certain point. I'd be interested to hear people's thoughts on this---it's got to be a small but maybe not insignificant minority of people with heart problems.

[3dragons]

Hi

I often have mild central pains that go up into my shoulders, back and down my left arm, sometimes for no obvious reason, and sometimes related to exercise (when I did it!) . But I also have many times with no pain at all. There is almost a constant pressure though, a feeling a bit like a seat belt that's too tight.

My docs suggested that for those of us athletes who end up with heart problems caused by viruses (as they suspect mine most likely is, as I dont drink, have healthy BP and cholestrol, no family history, healthy lifestyle etc), chances are that we may have not rested enough when we caught the initial virus and chose to train "through it".  This may then result in the body's immune system eing depleted and thus less able to fight the virus/infection.  Subsequently, there becomes and increased chance of the heart being affected, or if it is affected, reduced ability to successfully fight the infection.

The way I interpret that is not that high level performance athletes are more at risk of heart disease but that they may not rest when others may, therefore putting themselves at extra risk should they get an infection or virus.

But that is my interpretation. I like to think that because of the great care I have taken of my health, my quality of life (was) greatly improved, and perhaps my otherwise good health may have made me stronger and better able to cope with the strain this disease has placed on my body now. That's how I cope with this mentally, anyway. It makes me feel less like I was "at fault" (I can think of many times I have trained when I have had a cold, or gone to work when I was not well because there was no one else to do the class or I needed to pay my bills - guess that hasnt turned to be the best decision I ever made but one I have to live with for the rest of my life!).

[KMooreCPA]

Thanks for the response, took stress test and chest CT Scan yesterday, no results yet.  They have not mentioned the steriods as a cause, in fact, they haven't given me any explanation for a cause.  I will update everyone on the outcome of these tests as soon as I get the results.  The medicine "Avalide" that the doctor gave me, causes me to be comatose!  I can't function on it, so I have started taking it at night.  But during the day, I am breathless from simple tasks, but I am still working out, just a little lighter.  Thanks again for the info and inspiration on life after this diagnosis.

[3dragons]

Have the docs advised to modify your exercise at all? Did they suggest any link between the fluid on your heart to the shortness of breath? Intense exercise, such as strength training, weight lifting etc can cause a dramatic increase in blood pressure at the time of training - is the Avalide for BP? And by coatose, do you mean really spaced out, sleepy?  I take Coversil and Toprol, but they are to slow the heart rate, and block the affect of hormones on it (like adrenalin). I feel really tired on them, and more dizzy (than when sedentary) if I try to exercise, but dont have the same symptoms as you described, so am just curious...

[KMooreCPA]

The doctors have not been very helpful, except to scare me to death and cause confusion as to what I should do to correct this problem.  The condition is most certainly caused from long term use of steroids.  My life feels like it's falling apart because I am craving steroids now due to my stopping the steroids just 2 months ago.  I need some advice on how to get my testoterone back to normal levels without damaging my heart any further.  I have heard of a drug called HCG combined with clomid that will kick start the pituitary gland into producing the testoterone naturally.  I am just worried that it will have an adverse affect on the Avalide - which is a blood pressure medication that includes a diuretic (water pill).  I have also considered Winstrol which does not make the body retain water but does have the hormonal effects of testoterone.  I have to keep working out and I have to have something to keep me motivated.  I have decided that, I just need to know what is safe and what is not.  My BP at last reading was 140/100.  From what I've read, that's not all that terrible except that the 100 should be between 70-90.  If anyone can give me any advice, I am desperate!

[3dragons]

It sounds to me that you need to decide honestly what your priorities are; it may then help you make your choices more comfortably. You wrote that you need something to help keep you motivated... and I ask the question, "Motivated to do what? Keep training? Survive with symptoms? Survive and get rid of the symptoms?" Are you training for something specific at the moment, or is it more the lifestyle continuation? I suffered withdrawls from intense training for months. I am slowly starting to accept now that I need to turn my focus elsewhere because, in my situation, that lifestyle no longer is going to be mine. Goodness, I now have a disabled parking permit now just so I can make the distance from the carpark to the shopping centre/hospital/office entrance without needing to rest! Far cry from the Pump class followed by RPM and then a Yoga session to finish the morning off before my own training in the gym later the same day, after which I'd take the kids to the park, walk the dog and do some digging in the garden! I miss feeling "alive", and the endorphins physical activity gives you. Now, I am plodding around, and the things that used to excite me now make me feel worse. So, I am trying to pick up other skills, challenging myself by re-learning how to play the piano, and designing educational development games for junior learners. Not the same as racing motorbikes and exercising, but I want to live, so... Still adjusting to the necessary changes, but I am not going to let this misfortune over which I had no control (in getting sick) ruin my whole quality of life. Deciding your priorities may help give you the motivation to make the decisions best for YOU.

[rockcityaudiouk]

Hello,Please go to see a qualified cardiologist ASAP,an internist is simply not qualified to make such a diagnosis!.BUT if that diagnoisi is true, get yourself to the best cardiologist you can get hold of then you may well be ok for the future.mess up and continue and DEATH will be your outcome.You should not train with heavy weights AT ALL period.until this has been resolved.
you will need extensive tests like Echo cardiogram and possibly myocardial profusion scan
with a 64 slice CT angiography.(an possibly a calcium score)
Full CBC work up including Liver profile CRP and Trop((just to be safe)pericardial Troponin
this enzyme is found only in heart muscle so doctors can tell if your heart has been damaged.
When excess fluid collects in the sac  surrounding the heart, doctors refer to this as is effusion. It may be caused by inflammation of the pericardium (pericarditits). Signs and symptoms of may include:

Fluid retention (edema)
blood pressure
Shortness of breath
Dizziness or fainting
Chest pain
Cough
Fast heart rate or heart palpitations
Causes of pericardial effusion include:

Infection
Inflammatory disorders, such as lupus
Cancer that has spread (metastasized) to the pericardium
Kidney failure with excessive blood levels of urea nitrogen
(your long history steriod abuse could cause this)
Heart surgery
If the fluid accumulates slowly, the pericardium may initially stretch enough to accommodate it. Signs and symptoms may not occur until a large amount of fluid collects over time. Rapid fluid accumulation — even if the fluid amount is relatively small — can severely impair the function of the heart. Cardiac tamponade occurs when the pericardial effusion compresses the heart and prevents effective pumping of blood to the body. This can be life-threatening.

A doctor may confirm a diagnosis by:

Ultrasound of the heart (echocardiogram)
CT or MRI scan
Treatment depends on the underlying cause and the severity of the heart impairment. Pericardial effusion due to a viral infection usually goes away within a few weeks without treatment!. Some pericardial effusions remain small and never need treatment.   If the pericardial effusion is due to a condition such as lupus, treatment with anti-inflammatory medications may help. If the effusion is compromising heart function and causing cardiac tamponade, it will need to be drained, most commonly by a needle inserted through the chest wall and into the pericardial space. A drainage tube is often left in place for several days. In some cases, surgical drainage may be required.
Hope this helps.and please get yourself off steriods slowly but get yourself off them!.
Regards,
John(UK)