lvh

[almostsold]

my son is 24 and a strenght trainor no steriods. he was just diagnosed with lvh from an echogram. his reading was 20mm which the dr said was very serious but could be reduced with drugs. he was put on 2.5 mg of zestril and 50mg of atenolol for blood pressure which is ist stage.the drs told him it will shorten his life span by a couple of years. that seems odd for something they said is very serious. drs said contiue all other activity except strenght traing, his workouts include sprinting, joging, full contact martial arts, pull ups and pushups. this doesn't make much sense to me.
my questions are
1 is he in immediate danger
2 should he continue his other workouts
3 is he on the best drugs for regreesion
4 how much regreesion can be expected at best and how long does it take to strart the process.
thank you
leo

[CCF-M.D.-KE]

Left ventricular hypertrophy (LVH) is when the heart muscle is thicker than normal. This may result from a genetic cause, high blood pressure or a valve problem.  It is true that people with LVH don't live quite as long as those without. However, with medical therapy it may be possible to reverse some of the findings.

1. Given these findings he probably is at slightly increased risk of cardiac death than the average person at this time. However, every one is at some risk. With close follow-up, medical therapy and avoiding behavior which could worsen the LVH hopefully things will go well.  This is a condition which requires follow-up with echocardiography.

2. Isometric exercise can worsen LVH. Aerobic exercise would be a better choice for someone with LVH. Pull ups and push ups are a form of isometric exercise and I would avoid them.

3.His current drug regimen seems fine.

4. It is difficult to say over what time course the regression should take place. People don't all respond the same to medical therapy and some may not respond at all. Therefore, I would discuss this with your doctor.

Thanks for your question,


CCF-MD-KE

[arthur]

The left ventricle is often enlarged in athletes...my obviously naive comment is to ask whether this was taken into account by your doctor.  ...and if not, I would seek a second opinion, in particular, from a sports cardiologist.

[almostsold]

thanks arthur that was dicussed but the dr said an athletes average thickness is 13-14mm. my son was 20mm. that seems way out of proportion. i'm hoping someone tells me different.

[sman]

Leo,

What is your sons symptoms???  I am an athlete also and have had some issues with my heart as well.  I am wondering if he has similar symptoms to mine.

Thanks

Ken

[almostsold]

he never had any signs until the otherday when he had a series of pvc's. they came steady for a couple of days until he had enough of them to go to the hosiptal. he had just last month started a mild dose of zestril as he had entered first stage high blood pressure. heart disease runs in family. he thought the pvc's were due to stress so he ignored them. other than that he showed no signs of anything. the kid was a bull and his workouts were exhusting just to watch. let me note that he was not a body builder only strength training to enhance his martial atrs strength and to stay fit so as not to end up like me. obese heart attack and cabx4 all at 42

[sman]

Yes...I used to get 1000's of pvc's everyday for weeks...then all of sudden, they went away.  Now I only get a few a day, but they are very forceful.  I can feel my heart beat all the time, especially when I lay down on my left side...but my strees echo came back normal...I thought my heart was getting thicker and bigger because of my frequent and intense workouts, but it turned out that it was just a little thicker than normal.  I think your son should not work out so hard because I believe that a really thick left ventricle may be too stiff and has a tendancy to beat erratically at times...but I am no Dr.  Heck, my heart beats erratically, but I still exercise because it's part of my lifestyle.  All the best to you and your son Leo.

Ken S.

[shelley67]

Hi,
I am wondering about a "specific" part of your question.  You all mention the thickness being 20 mm, are you referring to the "left posterior wall thickness"?  I had an echo recently, and though it was not mentioned to me by the dr, i looked for info on normal values for ventricle size, etc, and I have a measurement called "LVPW", the others though pertaining to left ventricle are left ventricle (diastolic) measurement as well as systolic.  Do you know what those measurements were and if they were in normal limits?  I have been unable to find some of the info on those measurements to in fact see if i have hypertorphy, you would think a dr would mention it, but who knows.  Hope your son responds well to the therapy and is doing ok.
Thanks

[almostsold]

yes shelley the wall thickness. the rest you lost me on but when he goes back a month from now i'll see if he get any more info.

[No Bypass / No Stents]

I would say that Atenolol is a poor choice of drugs for a young, healthy, athlete.  It might be a good drug for an old man that has had a heart attack and spends most of his time in a chair in front of the TV.  It's effective in lowering blood pressure, but the side effects are counter productive for someone who is physically active.

I would suggest that your son get's off of it, but it is recommended to taper off.  I also think that the advice someone gave about a sports doctor or cardiologist is good advice.

PVC's are sometimes transient.  A year after my heart attack I began getting PVCs every time that I exercised.  It lasted about six months and then went away.  Now my heart is steady as a rock, even if I drink alcholol.

I think that the Zestril might be an ok choice.  I do think that Altace, another ace inhibitor, was partially responsible for the cessation of my PVC's.

Use the search function to look up past posts on LVH.  There is quite a few posts on it.

Remember that medications can make situations worse and make a healthy person sick.  I take $500 worth of cholesterol and BP meds each month, but believe that meds can mess up an otherwise health person.

[shelley67]

Do you have a copy of the report?  The measurments Im talking about are measurments taken in systolic and diastolic.  They would show on a report as LV(diastolic) or LV(sysytolic).....also sometimes referred to as end systolic and diastolic......im not sure if they are as diagnostic to hypertrophy or not, but those were the ones i was looking for answers or information on, thank you
shelley67

[briggsy]

My father has recently been diagnosed with silent ischaemia following a strongly positive exercise stress test.  Cardiac catheterisation yesterday confirmed triple vessel disease with good LV ejection.  The cardiologist said his case would be discussed with the cardiac surgical team before deciding whether or not he is suitable for CABG.  Is there any reason why he would not be suitable?  He is otherwise healthy, 63 years old, with no comorbidities, no HTN, not overweight, never smoked, teetotaller and a total cholesterol of 5.8.  He has been told to take things very easy as he does not experience chest pain and therefore would not experience warning symptoms.  He is on aspirin 75mg, bisoprolol 5mg, ramipril 2.5mg and pravastatin 40mg.  THe cardiologist will review him in 8 weeks.  Is there any other course of action that could be discussed with his family doctor in the meantime?

[almostsold]

shelley i'm sorry i don't have the report. he isn;t the tyre that would call and ask either. again maybe at his next appointment

[sman]

I have my echo report in front of me and it says:

LV Systolic Dimension (2.4-4.0)
LV Diastolic Dimension (3.7-5.6)
Posterior Wall Thickness (0.6-1.1)

I would read that as the normal ranges and anything above it high.

Ken S.

[shelley67]

The posterior wall though is assumably the measurement whcih is being used to diagnose lvh?  My reading on that is fine, the readings on the diastolic and sysytolic are the ones which are slightly increased, though i dont know what that means.

[TruthBeKnown]

Shelley~


You are correct in that the  Lt Venticular Posterior wall in Diastole is the measurment that determines whether or not you have LVH. Systolic  measurements aren't recognised much because when the heart is contracting or squeezing to pump that blood through it can thicken ect in its attempts  to do so,,,,so I don't feel that the systole  measurment is as accurate as *Diastole*, when the chamber is relaxed and filling with blood.


The thickness of the walls can be an early indication of cardiac disease,but that alone is not a serious cause of alarm.When the measurements are well above normal there should be cause for concern and further followup necessary,if a diagnosis is still in question.


Unless you have other abnormalities  that are noted on your exam,I would not concern myself with the systolic measurment of the LVPW being slightly or borderline enlarged.

[shelley67]

TruthBeKnown,
Thanks for the input, you sound like you know what you are taling about..I would like to find somewhere that tells normal ranges and values for the different measurements on an echo, but am having a hard time finding any that match, it seems a lot are different.  In any case, thanks for your msg.
Thanks