Really anxious about heart condition HCM

[lgrass94]

I am a very anxious individual, and am very fitness orientated to counteract all the panicking i do lol!
I trained from 16 upwards and now am 21. I used to train mainly just muscles, like moderate to heavy bodybuilding. Ive never taken steroids or hgh hormones or any enhancement drugs. I never used to think about my exercise back when i was 17 18 19 even 20. However around a year ago i started to worry about things as i noticed a couple of niggle sensations when i worked out. I was getting older and started lifting heavier and training harder and corporating some cardio in my routines. One time on the treadmill i felt a little chest discomfort and that was the root of my exercise / heart worry issues. I ignored it and a few months later i had extra beats during exercise. Naturally i got a heart work-up and had a 24 hr ECG, a resting ECG, an ECHOCARDIOGRAM and a STRESS TEST. My echo was fine, disnt even show the common MVP or anything. Completely normal. 24 hr holter ecg showed a couple of PVCS and a PAC. Since the tests i have really gone for it with training, sometimes twice a day, and started skipping 10/12 minutes every other day for a little weight loss. Since the more intense training, which has been going on for about 6/7 weeks now i have noticed more resting chest discomfort and sometimes shortness of breath with exercise. I feel a little wierd within the 4 or 5 minutes warm down of the exercise also, maybe where the adrenaline is cooling down? My pvcs or pacs have literally disapperared but surely my fitness and breathing should be alot better since ive been doing more cardio work? It doesnt make sense. It scares me. Could i have HCM? I have read alot of misdiagnosis stories.

[researcher09]

It is great to see that you have became healthier and de-stressed.  There was a recent interview of a world class ablation specialist in Utah and he talked about controlling AFib by improving habits eliminating symptoms in 50% of patients.  That's is a huge effect and people should realize that living a healthier life style gives you better odds of success than the average medicare center doing an ablation. The average medicare center does less than 25 AF ablation procedures per year, in fact 80% of centers that offer ablation services do less than 25 procedures per year.  The first steps to try is to improve living habits and de-stress, always.  If that doesn't work, consider ablation but only if you have access to experienced centers that do a lot of procedures, at least 100 per year in the case of AF.  The guidelines for skills maintenance is in the Heart Rhythm Society guidelines.  Link below is interview that I referred to.

http://www.innovationsincrm.com/cardiac-rhythm-management/articles-2015/85-september-2015/756-interview-with-john-day

[ivi210]

I used to be very anxious person. Special when it came to my heart problem. Tachycardia and PVC. I could not sleep not think how scared I was, but when I started to work on my self i done what I could to help me get healthily (like changing eating, fitness and life habits), went to doctor to see how scary my condition really is and then I just decided to relax. Worry cannot bring you no where. I still have sometimes heart arrhythmias but they do not lead my life and I putted them under control with like i said some life changing habits.
Wish you much luck and health.

[lgrass94]

Hmmm it's strange though as hcm is the leading cause of suddend Death in athletes as it's the most commom type of heart disease. The reason it probably isn't more then 500 is because alot of people with it live a sedentry lifestyle and don't aggravate it unlike athletes. It bugs me just as to why the individuals that do exercise throughout adulthood and don't get diagnosed until later life. It would either suggest it happens so quickly, example over 6 12 months. Or the fact they never had symptoms of it so they didn't think to go for a scan all them years they were training? It's strange

[researcher09]

I don't have an opinion about how those SCD incidents happened.  I am referring to ones that I learned of locally.  All were young athletes involved in running and had no prior symptoms.  However, all kids that want to be involved in endurance sports are offered screening at a low cost (around $80) and most of the cases discovered involve SVT-WPW and rarely do they find HCM.  The one case that my own doctor was involved in, the youth was suspected to have had WPW that degenerated into VT during a cross country meet.  You also hear about occasional cases of professional soccer players.  Exercise cardiomyopathy is supposedly reversible.

[lgrass94]

Also can i mention, I have read about hcm sufferers who say it took them 10 12 years to be finally diagnosed, and it wasnt being picked up? If this is the case, how accurate can a echo be?

[lgrass94]

I watched the video. Very interesting actually, looks like regardless of cardiomyopathy and things like arvc, scarring tissue can and does happen to the heart.

Regarding my training though, I never ever go into them depths with running. I perform around 40 minutes of skipping a week and perhaps 5 x 40 minutes on weightlifting a week. So usually one would expect the changes of the heart tissue to show on a athlete in perhaps football or basketball where you running along.

Hey researcher09, can I ask you opinion?
The heart related sudden deaths we here of, do you think it happens because they were too stubborn or perhaps had no symptoms to go get checked out? You think if most of them WERE to have attended a screening a year or more before then they wouldn't have had a cardiac arrest?

My partner is so sedentary is unbelievable! She says she doesn't want a ecg and has never had one in her life and doesn't see why she would want one. Alt of people live like this. Why?

[researcher09]

Links to artilcle and TED talk that I referred to -

http://espn.go.com/sports/endurance/story/_/id/13386980/velonews-

https://youtu.be/Y6U728AZnV0

[researcher09]

I don't know.  How hard were you training?  About a month ago, ithood and I posted a couple of items about over training.  There is an optimal point at which you improve heart health but then over that, you reverse the process and damage your heart.  One was an ESPN article and the other was a TED talk video from a heart doctor-scientist who used to train hard,  until he found out through his research that he was over training.  

My sister has a lot of life guard friends that enjoyed the rigors of training as part of their job.  Many of her friends found they have heart rhythm issues as they aged consistent with what the ESPN article and heart scientist found.  I had a work friend that ran numerous marathons and died during a business meeting.  The irony was that he ran marathons because he was afraid of dying from heart disease that his dad died from when he was young.  Moderation is the key, I think.

[lgrass94]

Ok I see. We'll he had a sedentary lifestyle, smoked a lot and was meant to be taking warfarin for severely high blood pressure. He stopped taking it for a while, kept missing doses etc.

Considering I trained from 17 upto now and I had the echo late 2014, would of allowed enough time for hcm to show itself through the 4 years? Do you think? Or perhaps it wasn't being aggravated because I wasn't focusing on cardio?

I know no one can tell me for sure what the future hold I understand that, it's just I'm abit like a car enthusiast, a car enthusiast won't worry about anything on a motorbike because his soul purpose is his car and how it looks. I never worry about tumors or embolisms etc as I don't live for them things. I live for exercise, which is why I'm so heart scared. If things go wrong with my heart then I'm screwed!

But back to hcm. Let's say someone has hcm, doesn't know about it. Has an echo and is given all clear. How long would they have to train they're heart for it to display significant growth and thickness? Months, years?

[researcher09]

The doppler echo would have shown septal thickening if you had it.  Your family history doesn't indicate HCM.  HCM leads to VF/VT and sudden death.  Heart attack after sex is probably an ischemic event and not because of HCM.

[lgrass94]

Hi guys, I really appreciate you taking the time to write on my post, it means a lot having outsiders opinions and general knowledge on things, sometime the doctors are not with is long enough to explain these things. For tacolino - your explanation for suspecting it is correct, I don't show any abnormal changes on my ECG let alone a clear echo. But I worry that as I step up my routines, it may add strain to my heart and bring out thickening Of the heart. I can workout for myself you do not have to be a athlete to aggravate hcm if you have the faulty gene, and it can present at any age. You not think though, now I genuinely am training cardio more that it's strange I don't seem to becoming fitter?  To researcher09 - no I haven't had a 3d echo, I believe I had a Doppler echo? Same thing that they use on pregnant women, they even checked my valves leading to stomach to make sure they function we'll and there's no blockages. Also no, I don't have any prominent heart related deaths in the family, only my granddads brother, who was 45, he had several heart attacks and finally one after sexual intercourse, and was never revived. I don't have access to his records and it was 20 years ago almost so the family members don't know where to locate his death certificate etc. to is something wrong - thank you for writing on here. I fully understand your comment , sure enough it would of shown in late 2014 when I had the echo, however of I wasn't training cardio work hardly at all, then maybe it wouldn't of aggravated It, if it was there? As a cardiologist said on a Column on young athletes dying " just because one has a clear echo scan when they're 16 or 17, doesn't mean it won't change 2 or 3 years later " . That's why I'm concerned.

Once again thank you everybody, I love medhelp, nobody is silly with responses either. Thanks guys

[is_something_wrong]

If your echo is normal (no excessive left ventricular thickening) you don't have HCM. It's as simple as that :-)

In "athletic hearts" and LVH due to hypertension, the septum wall and posteror wall tend to grow about equally. With HCM, the septal wall is usually far thicker than the posterior wall.

[researcher09]

HCM is usually inherited and rare.  I doubt it is anything that extreme.  If you are worried, have a 3D echocardiogram done and they will measure EF and septum thickness.  My son had that done when he was running cross country and had a synscope episode where the ER doc suspected he had HCM.  Not even close, the ER doc didn't know what he was talking about.  Did you have HCM in the family tree?  Is that why you asked?

[tacolino]

Hi there. Its doubtful it could be HCM. Your tests would have shown the abnormalities associated with it.
The ECG would have shown electrical abnormalities
The stress test would also give indications
The ECHO is the best test for it. . . yours was normal.
You don't appear to have Electrical problems, Ventricular thickening or any functional impairment. I'm not a doctor, but to the lay man you look in good shape. If there was the slightest doubt, you would be getting an MRI test, which some consider the gold standard test.
I think you will probably be adopting a wait and see approach, considering the test results already available. In the meantime as you admit yourself, you seem to stress a lot and that may be the major underlying issue here?

[MichelleP_3811]

Only a doctor can tell you for sure but since you had a very clean work up prior it is probably not likely you have HCM. The heart is a muscle though and like any muscle it can get strained so maybe ease back a little on the intensity and give your heart a little break and see if it improves.  If not go and get checked out to be sure all is OK.