Enlarged heart

[Jim4986]

I'm 46 years old and have been told by my doctor I have a slightly enlarged heart and 2 enlarged valves. I've never smoked, don't do drugs,I drink socially although that is limited because I only have 1 weekend off a month and I don't drink during the week. I exercise (lift weights, not much cardio) 3 days a week, and have a job that keeps me active. I am in pretty good shape, 6'2" and 200 pounds. I was just wondering, what causes this in an otherwise healthy person? I had 2 bouts of Atrial Fib, one about 10 yrs. ago and the other about 20 yrs. ago. My Doctor can't seem to tell me much. Is this an early death sentence, or can it be reversed or controlled? He has me on 25 mg of  Metoprolol a day to keep my heart rate down. I have low blood pressure and he told me to exercise more (cardio). Now isn't that defeating the purpose of the Metoprolol? Can I maintain an active lifestyle? I kayak, hike, hunt, ride mountain bike. Any info would be apprieciated, thank you.

[kenkeith]

There is an oversight in terms (remodeling and reverse remodeling) and that is  confusing when reading the thread.  Ventricular remodeling (or cardiac remodelling) refers to the changes in size, shape, and function of the heart after injury to the ventricles. The injury is typically due to acute myocardial infarction, but may be from a number of causes that result in increased pressure or volume overload (forms of strain) on the heart as associated with high blood pressure.  Controlling bp and volume overload can reverse remodeling (dilated LV)...It hppened in my case

"Chronic hypertension, congenital heart disease with intracardiac shunting, and valvular heart disease may also lead to remodeling. After the insult occurs, a series of histopathological and structural changes occur in the left ventricular myocardium that lead to progressive decline in left ventricular performance. Ultimately, ventricular remodeling may result in diminished contractile (systolic) function and reduced stroke volume".

To Jim: I agree with Jon.  Finding the underlying cause and successfully treating will/can reverse remodeling (depending on the cause).  A diseased hypertrophied heart tend to relax more slowly after contraction (slower  recovery), reduces filling space, and develop less power, whereas the athletic heart is capable of performing normally. An endurance athlete's heart preserves the ratio of the left ventricle wall thickness to cavity radius within the normal range as apposed to the physiological change in the pathological heart where wall thickness is proportionaly larger.  Also, the healthy heart will have a lower heart rate at rest and for some less than 60 bpm and the chamber size will return to a more normal dimensions when deconditioning, and the pathologically enlarged heart will not.

[Jim4986]

The doctor has told me it's cardiomyopathy, don't remember hearing anything about athlete's heart, which I have to believe is only for world class athletes. How life altering is this?

[grendslori]

That's not always true about the athletic heart. Anytime the heart is hypertrophied, the first thing they consider is this type of enlargement. They even considered it in my 6 year old daughter and she certainly wasn't a world class athlete (especially having juvenile rhuematoid arthritis!) There are differences in the two forms of enlarged hearts and they are easily diagnosed from one another. The heart does not always remodel itself either, it depends on the degree of heart disease.

[erijon]

Probably not an athlete's heart, that is normally only seen in world class athletes. You need to know if your heart is enlarged due to a thickening of the walls or to a stretching of the wall. the key is to find the underlying cause that is making your heart work harder than it should and treat that, then the heart can remodel itself.

Good luck,

Jon

[grendslori]

The first thing you want to ask your doctor is: do you have a cardiomyopathy or do you have an athletic heart, especially that you work out. Once you have those questions answered, you can get the answers to the resat of these questions. One can be life altering, the other is harmless.