Athlete's Heart

[sailing123]

(40 year old male) - I had an echo completed about 6 months ago showing an mildly enlarged left ventrical. Left ventrical at 60mm, with normal EF.  An MRI was also done - all of test taken indicated a normal heart other than the enlargement, resting bpm high 50's to mid 60's.  No traces of hypertopgy either.  Also, I have no symptoms, I normally feel fine to great.  My cardiologist diagnosed me with an Athlete's Heart.  I was very active especially with working out 5-6 times per week, for many years, both running and heavy lifting.  My only concern is that I was a heavy drinker in my 20's & early 30's, however only an occasional drinker since.  I have been attempting to decondition myself to see if the ventricle would reduce in size.  How long should this take?  When should I get tested again?  Any other thoughts?

[Lee Kirksey, MD]

Hello
Im not sure that I understand completely the question. Are you having any symptoms attributed to your heart ie shortness of breath, syncope, chest discomfort? Is the question how you get your heart to look like someone's who has not exercised all of their life or is the question what can be done to determine if your  heart is showing signs of DCM

Without having examined you or reviewing your studies, it seems that your cardiologist is not too worried about your findings and has attributed them to your conditioning. It does not seem that allowing yourself to become deconditioned at the age of 40 would be the best strategy for your long term health. Instead, it seems reasonable to continue to exercise wisely and consider having a comparative study performed at some time in the future to determine that no changes have occurred. It does not seem that your doctors have labeled you with a "dysfunction". Isn't that true? A stress echo would seem to be a reasonable test for comparison.

In general, I think it is not a good idea to treat test results and ignore the whole picture surrounding the patient.

Good luck and Happy New Year

[sailing123]

Additional info.

The left atrium was also mildly enlarged.
No evidence of Hypertrophic Cardiomyopathy.
I'm 5-10 / 165 lbs (I'm down 5 pounds to 160 since I've reduced my working out).
Blood Pressure 120-70
Diet is generally good

Test:
EKG
Echo (x 3)
Nuclear Stress
MRI
XRay
Lab Work

My initial echo showed an EF at 46% to 50% depending on view, LVED 68. The technology of the machine was older.  However the gated nuclear stress (next day) showed EF at 59% & LVED 60.

(2 weeks later at Cleveland Clinic), an MRI showed an EF at 59%, LVED 60.  2nd Echo was taken again showing EF in the high 40's to low 50's, LVED 60.

I had a third echo about two months after and it showed EF again at 59%.

All of the test showed everything else as normal (except for the mild dilation).  My Cardiologist from The Cleveland Clinic diagnosed me with an Athletic Heart, not DCM.

I've really cut back my workout routing to see if the dilation would reduce.  My question is how long should I wait before traveling back to Cleveland Clinic to get another, more accurate test? (stess echo maybe?) How long will it take to decondition & remodel?

Can EF improve on it's own without medication if there is dilation with dysfunction?