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-   -   Apparently I have an enlarged heart... (http://www.bikeforums.net/commuting/929991-apparently-i-have-enlarged-heart.html)

jpatkinson 03-27-14 01:03 AM

Glad to read you have a diagnosis to explain your symptoms. HCM is genetic, and not everyone has the same severity of disease. My understanding (I am a primary care doc) is that for patients with this disease, we tend to advise 1) avoidance of volume depletion (don't get dehydrated!), 2) restriction from intense physical activities such as most competitive sports (this is worth discussing with your cardiologist after your second echo), 3) controlling heart failure symptoms and chest pain (though you aren't at this point) and 4) screening of first-degree relatives (get your kids checked!). I think I would inquire about getting a stress echo (echo while exercising). The huge risk here is sudden cardiac death -- your cardiologist should be able to tell you how much is "too much," so you can continue to enjoy cycling! - JP

PatrickGSR94 03-27-14 07:28 AM

Yeah they did talk to me about staying hydrated. Also he did say cycling is good but "don't do those 100-mile races or anything". Well, I'm not a racer by any means, but I feel like I could probably do a century ride as long as I wasn't pushing myself hard the whole time. Might take me 8 hours to complete but I think I could do it.

jfowler85 03-27-14 11:27 AM

Are we talking cardiomegaly or ventricular hypertrophy or something else?

PatrickGSR94 03-27-14 03:52 PM

From what I understand "cardiomegaly" is the general condition of an enlarged heart, which could be caused by different things. In my case it's HOCM or hypertrophic obstructive cardiomyopathy.

DowneasTTer 03-27-14 04:12 PM

Quote:

Originally Posted by jpatkinson (Post 16615582)
The huge risk here is sudden cardiac death -- your cardiologist should be able to tell you how much is "too much," so you can continue to enjoy cycling! - JP

Well PatrickGSR94 if the above is true, you might become a member of a really select group of riders.... the ICD guys. I have a single lead model that is like having a little heart doc on board 24/7 (well ok maybe more like that pimply faced kid with the EMT uniform and the paddles). BUT STILL...Much better than SCD. Whatever the outcome I sure you will be able to continue riding and enjoying life. Good luck.

work4bike 08-10-16 06:50 AM

I know this is an old thread, but this most recent article is very interesting and very much applies.

Regular exercise can lead to heart disease misdiagnosis


Quote:

“It’s well known that the hearts of endurance athletes adapt in response to exercise, a phenomenon called ‘athlete’s heart’. This study is the first to show that healthy adults who do regular exercise may also develop enlarged hearts. As a result, there’s a risk that some active adults could be misdiagnosed with heart disease,” says Dr Declan O’Regan, of the MRC Clinical Sciences Centre, at Imperial College London, and one of the lead scientists on the research.

SloButWide 08-10-16 11:28 AM

Quote:

Originally Posted by PatrickGSR94 (Post 16613391)
So yeah, I'm guessing this condition may be why I haven't gotten any better or faster at cycling over the last 1-2 years. Hills are still hard, I'm still slow, I still huff and puff and all that. I'd love to be able to average 16-17 MPH on a ride but unfortunately that may never happen. My best so far has been 15.2 MPH riding home from work with a 20+ MPH tail wind. Without that I rarely can break into the 14's.

While it can be discouraging to not get better, you're probably much healthier because of cycling. As someone said of golf, "If you're not on the Tour, we're all competing with ourselves." If improving is your goal, keep working towards it and know that you'll proceed at your own pace. My ex was more miserable about not being able to accept her physical limitations than the condition that caused them; her quality of life improved when she was finally able to accept that all she could do was all she could do.

I-Like-To-Bike 08-10-16 11:45 AM

Quote:

Originally Posted by SloButWide (Post 18975382)
If improving is your goal, keep working towards it and know that you'll proceed at your own pace. My ex was more miserable about not being able to accept her physical limitations than the condition that caused them; her quality of life improved when she was finally able to accept that all she could do was all she could do.

I recommend that the OP sets as his chief goal with his bicycling is to enjoy every ride at whatever speed/distance is comfortable and enjoyable, and not to set ANY goal based on go faster or go farther.

I recommend that the OP also ignore all Internet postings/bike club bragging about how far or how fast other people may ride. He is not in competition with them, no reason to fret about not meeting other people's goals.

Darth Lefty 08-10-16 12:40 PM

Quote:

Originally Posted by work4bike (Post 18974604)
I know this is an old thread, but this most recent article is very interesting and very much applies.

Regular exercise can lead to heart disease misdiagnosis

HCM is sort of a bucket for a lot of subtly different heart problems. I can't speak for Patrick, but my own condition is hereditary and linked to a specific gene inherited from my Amish-descended dad's side of the family. This is not a theory, I've had the gene test. I've always had a murmur but other than that I was asymptomatic til my early 30's. I'm under doctor's orders to avoid weightlifting in order to avoid adding "athlete's heart" to the underlying problem.

http://www.wohproject.org/disorders/...yhypertrophic/

jfowler85 08-10-16 10:27 PM

Secretariat had one too. Pedal harder.

Also: please ignore internet medical advice, for the good of your health.

Darth Lefty 08-11-16 11:20 AM

Quote:

Originally Posted by jfowler85 (Post 18976804)
Secretariat had one too. Pedal harder.

Also: please ignore internet medical advice, for the good of your health.

I know you're joking, but I feel like writing this anyhow.

In my own condition, the left chamber and the septum are enlarged. Additionally, by the valve, there is an especially thick knob of muscle, making a hard turn for the blood flow, causing a larger pressure drop and poorer ejection from the chamber. Besides the physical shape, the mis-growth also caused some minor electrical problems. I do get chest pain, daily, so "pedal harder" doesn't work for me.

As for Secretariat,
Quote:

A necropsy revealed his heart was significantly larger than that of an ordinary horse.[124] An extremely large heart is a trait that occasionally occurs in Thoroughbreds, hypothesized to be linked to a genetic condition passed down via the dam line, known as the "x-factor".[124]
[129]
[130]
[131] The x-factor can be traced to the historic racehorse Eclipse, who was necropsied after his death in 1789. Because Eclipse's heart appeared to be much larger than other horses, it was weighed, and found to be 14 pounds (6.4 kg), almost twice the normal weight. Eclipse is believed to have passed the trait on via his daughters, and pedigree research verified that Secretariat traces in his dam line to a daughter of Eclipse.[124] In the 20th century, the heart of Phar Lap was weighed and also documented to be 14.0 pounds (6.35 kg),[132] or essentially the same size as that of Eclipse.

At the time of Secretariat's death, the veterinarian who performed the necropsy, Dr. Thomas Swerczek, head pathologist at the University of Kentucky, did not weigh Secretariat's heart, but stated, "We just stood there in stunned silence. We couldn't believe it. The heart was perfect. There were no problems with it. It was just this huge engine."[29] Later, Swerczek also performed a necropsy on Sham, who died in 1993. Swerczek did weigh Sham's heart, and it was 18 pounds (8.2 kg). Based on Sham's measurement, and having necropsied both horses, he estimated Secretariat's heart probably weighed 22 pounds (10.0 kg), or about 2.5 times that of the average horse (8.5 pounds (3.9 kg)).[124]

jfowler85 08-12-16 03:54 AM

Quote:

Originally Posted by Darth Lefty (Post 18977987)
I know you're joking, but I feel like writing this anyhow.

In my own condition, the left chamber and the septum are enlarged. Additionally, by the valve, there is an especially thick knob of muscle, making a hard turn for the blood flow, causing a larger pressure drop and poorer ejection from the chamber. Besides the physical shape, the mis-growth also caused some minor electrical problems. I do get chest pain, daily, so "pedal harder" doesn't work for me.

As for Secretariat,

[gratuitous wikipedia citation]

1) pedal through the chest pain.

2) don't cite wikipedia.

PatrickGSR94 08-14-16 06:25 PM

Quote:

Originally Posted by work4bike (Post 18974604)
I know this is an old thread, but this most recent article is very interesting and very much applies.

Regular exercise can lead to heart disease misdiagnosis

In my case the echo test shows a backwash between chambers, so I'm pretty sure there's no mis-diagnosis. But my doc says as long as I can continue without any debilitating symptoms, I'm good to go. I'm up to 50 mg of metoprolol tartrate per day (25mg twice/day), still only $4 a month though so that's good. The cost of the dang echo tests is darn near debilitating, though, even after insurance. :mad:

Quote:

Originally Posted by I-Like-To-Bike (Post 18975420)
I recommend that the OP sets as his chief goal with his bicycling is to enjoy every ride at whatever speed/distance is comfortable and enjoyable, and not to set ANY goal based on go faster or go farther.

I recommend that the OP also ignore all Internet postings/bike club bragging about how far or how fast other people may ride. He is not in competition with them, no reason to fret about not meeting other people's goals.

It's not so much other people's goals, it's just the desire to want to be able to go a certain distance in less time, such as doing my 31 mile round trip commute in less time.

Quote:

Originally Posted by jfowler85 (Post 18979657)
1) pedal through the chest pain.

2) don't cite wikipedia.

3) DO NOT follow jfowler's advice. Always seek immediate medical attention for any prolonged chest pain.

jfowler85 08-15-16 07:12 PM

Quote:

Originally Posted by PatrickGSR94 (Post 18984844)
3) DO NOT follow jfowler's advice. Always seek immediate medical attention for any prolonged chest pain.



1) You're not following the thread. I am employing sarcasm in the context of my own earlier comment wherein I stated explicitly to not follow medical advice from this conversation.


2) Always seek medical attention for any chest pain, not just "prolonged" cp. Waiting too long increases the risk of permanent infarct damage.

gulfcoast 08-15-16 08:15 PM

It´s always unsettling when you hear something unexpected about your own health. I had a very similar experience in my mid 20´s when I was diagnosed with Aortic Valve Insufficiency. What this diagnoses did was truly make me take my health seriously and heighten my awareness of diet, exercise, and consistency in a overall healthy lifestyle. I am a better athlete now then before and very in tune with my limits. Cardiology has made amazing advances in the past decade and you probably have many more advantages in tests and better treatment options than your Father or earlier generations. Have hope and know cycling will still be in your future. One other thing, always get a second opinion before taking action. Good luck and take care.

InTheRain 08-15-16 09:44 PM

Just wondering if you would consider an e-bike. You can make your rides as hard or as easy as you want by adjusting the level of pedal assist. I use it because I'm not as fit as I should be on certain rides (also my main commuter.) Their are a few hills that I can avoid the "walk of shame" by using pedal assist. I don't have the throttle hooked up on my e-bike, but that's also an option when you just feel like you shouldn't push hard (it does drain the battery much more quickly.) E-bikes can keep people cycling for long after many feel like they should have stopped.

PatrickGSR94 08-16-16 11:53 AM

Quote:

Originally Posted by InTheRain (Post 18987742)
Just wondering if you would consider an e-bike. You can make your rides as hard or as easy as you want by adjusting the level of pedal assist. I use it because I'm not as fit as I should be on certain rides (also my main commuter.) Their are a few hills that I can avoid the "walk of shame" by using pedal assist. I don't have the throttle hooked up on my e-bike, but that's also an option when you just feel like you shouldn't push hard (it does drain the battery much more quickly.) E-bikes can keep people cycling for long after many feel like they should have stopped.

lol I've been considering and WANTING to do a BionX setup on my heavy utility bike, like wanting really badly, for quite awhile now. Problem is I just can't drop $2,000 or near that, for what a quality setup like BionX costs. I've looked at Bafang mid-drive units, but I've heard of a number of people having issues with the plastic internals after a couple thousand miles.

And yeah I would probably never use a throttle. At least pedal assist would make it feel less so like I'm "cheating". :p

I could do it if I sold my car and we went to a 1-car family, especially since we just bought a near-new car for my wife last week. But I just can't see us doing that. There are times when we both need separate vehicles. And days like today, with heavy rain showers, I don't think an e-bike would be very good for a 15 mile each way commute, and especially not a regular bike. I don't want to be out in that for that long.

Korina 08-16-16 12:21 PM

Quote:

Originally Posted by InTheRain (Post 18987742)
Their are a few hills that I can avoid the "walk of shame" by using pedal assist.

Don't think of it as a "walk of shame", think of is as a challenge to be conquered. :thumb: Mine is a very, very steep hill at the end of my ride home; initially I pedaled about 1/3 and then walked, then I was able to pedal the whole thing with lots of stops, then fewer stops, then three stops, then two, and a week ago I did it with one stop! (And then my wacky period came and I haven't been able to ride at all. ::fumes::)

Darth Lefty 08-16-16 02:58 PM

Quote:

Originally Posted by InTheRain (Post 18987742)
Just wondering if you would consider an e-bike.

You know, I have. My pace is about 10-12 mph. Upping that to 15 mph wouldn't make a lot of difference to my time to get home and would shorten my workout to less time than I'd like. I've decided I'm ok with going slow. If my condition worsens I'll revisit that decision.

InTheRain 08-16-16 05:29 PM

Quote:

Originally Posted by PatrickGSR94 (Post 18988888)
lol I've been considering and WANTING to do a BionX setup on my heavy utility bike, like wanting really badly, for quite awhile now. Problem is I just can't drop $2,000 or near that, for what a quality setup like BionX costs. I've looked at Bafang mid-drive units, but I've heard of a number of people having issues with the plastic internals after a couple thousand miles.

And yeah I would probably never use a throttle. At least pedal assist would make it feel less so like I'm "cheating". :p

I could do it if I sold my car and we went to a 1-car family, especially since we just bought a near-new car for my wife last week. But I just can't see us doing that. There are times when we both need separate vehicles. And days like today, with heavy rain showers, I don't think an e-bike would be very good for a 15 mile each way commute, and especially not a regular bike. I don't want to be out in that for that long.

That's what I have... BionX. I converted my touring bike to an e-bike. It has always been my main commuter but it has become so much more fun and convenient with the pedal assist. My commute is about 7 miles each way. I feel it's too short. 12 miles would be my ideal distance but I would enjoy 15. Rain is the norm around here for 9 months of the year. We have three drivers and two cars. I've driven a car to work less than five times in the last 20 months since my daughter got her driver's license.

Anyway, I understand that a BionX is a very large initial investment. I have about $5000 into the BionX, bike, accessories, and commute clothing. I've seen several threads about commuting by bicycle and saving money... it's not a discussion that needs to be gone through again. I ride because I prefer it over driving to work. I have an ideal commute on a bicycle. It's an option that can keep you riding if you love it and find that you may have physical limitations.

PatrickGSR94 08-16-16 07:12 PM

Quote:

Originally Posted by InTheRain (Post 18989781)
That's what I have... BionX. I converted my touring bike to an e-bike. It has always been my main commuter but it has become so much more fun and convenient with the pedal assist. My commute is about 7 miles each way. I feel it's too short. 12 miles would be my ideal distance but I would enjoy 15. Rain is the norm around here for 9 months of the year. We have three drivers and two cars. I've driven a car to work less than five times in the last 20 months since my daughter got her driver's license.

Anyway, I understand that a BionX is a very large initial investment. I have about $5000 into the BionX, bike, accessories, and commute clothing. I've seen several threads about commuting by bicycle and saving money... it's not a discussion that needs to be gone through again. I ride because I prefer it over driving to work. I have an ideal commute on a bicycle. It's an option that can keep you riding if you love it and find that you may have physical limitations.

I have my custom-built utility bike that started life as a steel frame MTB before I got just the frame, and built it up as a Dutch-style upright bike with disc brakes, that I use for hauling a trailer to the grocery store or just tooling around town. I think all I would need is the BionX kit by itself. Everything else should be good to go. It's very hard hauling a heavy load of groceries on the hills around here, for 4 miles from the store back to the house.

Only thing I really need to add to the bike is fenders, to make it "complete".

So your BionX setup does fine in the rain?

InTheRain 08-17-16 07:32 PM

Quote:

Originally Posted by PatrickGSR94 (Post 18990018)
I have my custom-built utility bike that started life as a steel frame MTB before I got just the frame, and built it up as a Dutch-style upright bike with disc brakes, that I use for hauling a trailer to the grocery store or just tooling around town. I think all I would need is the BionX kit by itself. Everything else should be good to go. It's very hard hauling a heavy load of groceries on the hills around here, for 4 miles from the store back to the house.

Only thing I really need to add to the bike is fenders, to make it "complete".

So your BionX setup does fine in the rain?

No problems at all in the rain. I bought the kit and had it installed by the ebike store in Portland, OR. I asked if it would be fine in the rain. The owner told me, "if it didn't do well in the rain, I would have been out of business within the first year... it rains here ten months out of the year." My BionX bike is my main commuter - 80 percent of commutes. I have fenders, they are absolutely necessary here if you commute by bike. If you aren't super handy with a wrench (maybe you are if you've built up a bike) I would highly recommend having your BionX system installed by an authorized dealer. They have software to make all different types of adjustments and to perform all types of diagnostics. They will register your system with BionX and it adds a year to your warranty when installed by an authorized dealer. The warranty goes from 2 years to 3 years. I haven't ever had to return to the dealer since the install (18 months and several thousand miles.) I have been extremely happy with the performance of the BionX system.


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