Pediatric Heart Expert Forum
Left Ventricular Hypertrophy
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Left Ventricular Hypertrophy

My 16 yr. old son failed his sports physical due to high blood pressure (160/100). He had an EKG and ECG and the ECG revealed mild left ventricular hypertrophy.  He participates in football and had been lifting weights 4x's a day prior to his physical (lifting 315 lbs and squating 400 lbs.). He is 5"10" and weighed 205 lbs at physical but is now 199.  He was using the Muslce Enhancement Supplement-NO Xplode.  I am wondering if the "quick" muslcle mass is what has cuased the HBP which has caused the LVH.  I am also concerned and wondering what this condition will do for his participation in football.  His BP was rechecked today and was 137/76.  
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Dear Medmom,

I do not believe that your son’s findings are necessarily due to quick muscle mass gain.  For our other readers, ECG and EKG are both short for electrocardiogram (EKG is the German, as that is the birthplace of the electrocardiogram).  Left ventricular hypertrophy (LVH) means that the pumping chamber on the left side of the heart is thickened.  I will say that ECGs are very good for assessing heart rhythm but only okay for assessing chamber size, and can frequently overestimate left sided hypertrophy.  That said, LVH can certainly occur in the setting of high blood pressure as “target-organ damage.”  His blood pressure is definitely elevated in BOTH measurements.  We assess blood pressure based on gender, age, and height.  Based on his parameters, 130 mmHg is the 90th percentile, or upper limits of normal for his systolic blood pressure, the upper number.  

High blood pressure, or hypertension, is not only bad for football participation, it’s bad for the brain, heart, and kidneys.  Activities that cause elevated blood pressure include isometric activities, such as weight-lifting, football, and wrestling.  Therefore, he should not be allowed to play football nor should he be allowed to weight train until his blood pressure normalizes.  Of note, his height is between the 50th and 75th percentile for age and gender, but his weight is greater than the 95th percentile.  Despite his weightlifting, I cannot tell if he has some aspect of obesity as well.  Football players are often looking for ways to “get bigger”, which includes weight training, but can also include supplements, overeating, and steroids.  These last 3 can be quite dangerous from a health standpoint.  There are increasing data to demonstrate that professional football players, despite their amount of strength training and physical activity, have early diabetes and coronary artery disease.  Thus, I strongly urge you to have your son evaluated by his primary care provider to not only assess the cause of his hypertension, but also to make sure that he is going about his weight training and adolescent growth in a healthy way.  This evaluation may also include evaluation by a cardiologist to assess him with history, examination, and an echocardiogram to ensure that he does not, in fact, have LVH or any other cardiac etiologies for his hypertension.
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The Children’s Hospital of Philadelphia
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