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Old 01-15-14, 02:01 PM   #1
PatrickGSR94
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Apparently I have an enlarged heart...

I sure hope this doesn't affect my commuting or cycling in general.

I went to the doc in December because of respiratory/sinus infection type junk. During the exam the doc said he thought I had a heart murmur or something like that. Had an ECG test performed last Monday, and today they called back saying I have this condition where my heart is enlarged, and it needs further evaluation by a cardiologist.

I'm about to turn 34 and have never had any health issues my whole life other than being a bit overweight. The doc told me 2 years ago my cholesterol was a bit high and I should lose 15-20 pounds. That's when I started running and actually lost 25. However my father has a hereditary heart condition that falls within the realm of "enlarged heart", and he was never able to be as active as I am today. About 10 years ago he had to get an artificial heart valve and a pacemaker.

I know I'm slow on the bike. I rarely average more than 14.0 MPH moving on a ride, and have yet to break 15 MPH. Usually it's in the 12-13.x range. I routinely get out of breath and have to breathe really hard on some climbs, but isn't that normal? Trouble is, in nearly 2 years and well over 2,700 miles of riding, I haven't really gotten any better or faster. Before I was cycling, I was running and worked up from running 45s at a time to running for 30 minutes, but it was still very slow at 14:xx minutes per mile.

So I'll have to see a cardiologist soon. I pray he won't tell me to stop riding my bike or something like that, because frankly I just don't know if I can do that.
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Old 01-15-14, 02:09 PM   #2
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Hopefully it's nothing serious. Was he never able to be active or was he just not ever active and it degenerated to the point where he couldn't be active? My father has heart issues as well, multiple heart attacks, but he was a smoker and drinker. He used to be in decent shape. Was in the national guard and had to be able to run certain distances. However, he was not a runner or cyclist or anything along those lines.
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Old 01-15-14, 02:20 PM   #3
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No, in high school my father was not able to participate in many of the physical activities in PE because of his condition. And because of not being able to be very active, he ended up being overweight, which I'm sure made it worse. He always had problems walking up much of any incline or steps, sometimes having to stop for a minute at the top of or even in the middle of single flight of steps. However he was never a smoker or drinker, so it really was all because of his heart condition. He took medication daily for decades before the pacemaker and artificial valve. I'm sure he still takes some now but not sure what.

My father actually did not get drafted for the Vietnam war because of his condition, something which I'm thankful for because I might not even be around if he had been sent over there.

I'm sure most of my weight issues are because my diet kind of sucks. I've also never had much issue going up inclines and steps. I may get a little out of breath every now and then but nothing major. So hopefully my condition won't be a big deal.
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Old 01-15-14, 02:23 PM   #4
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No, in high school my father was not able to participate in many of the physical activities in PE because of his condition. And because of not being able to be very active, he ended up being overweight, which I'm sure made it worse. He always had problems walking up much of any incline or steps, sometimes having to stop for a minute at the top of or even in the middle of single flight of steps. However he was never a smoker or drinker, so it really was all because of his heart condition. He took medication daily for decades before the pacemaker and artificial valve. I'm sure he still takes some now but not sure what.

My father actually did not get drafted for the Vietnam war because of his condition, something which I'm thankful for because I might not even be around if he had been sent over there.

I'm sure most of my weight issues are because my diet kind of sucks. I've also never had much issue going up inclines and steps. I may get a little out of breath every now and then but nothing major. So hopefully my condition won't be a big deal.
On a side note my father being drafted to the Vietnam war likely had much to do with his drinking.
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Old 01-15-14, 02:24 PM   #5
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First thing is to not worry. That causes more problems than any solutions. Know that many of us have heart problems and still continue to ride. The best thing to do is find a cardio guy that has both knowledge and personally. It took me 3 tries at the apple before finding the "right fit for me". I have chf (congestive heart failure) the cause is unknown but my left venticle is enlarged and my EF (ejection fraction - amount of blood in the LV pumped out on each contraction) is around 20%. You'll have to learn a whole new set of language but it becomes second nature in a slow time. I had to change my diet, take meds and in my case have an ICD (implantable cardioverter-defibrillator) implanted. On the positive side I have never felt better than in the past couple of years after finding out my heart problems. It appears I had a problem for a long time and lost a lot of function before starting to control it. You appear to be finding the problem early on. Oh, and about riding. Last year my wife and I had our best year…… over 8,000 miles….yes a little slower than a few years ago. But still not bad for a guy 65 years old and as my wife lets me know half a heart…. and she's not talking about heart disease. Good luck, find the right cardio doctor, and follow his/her advice. You'll be around the bf for many many miles to come.
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Old 01-15-14, 02:27 PM   #6
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Yeah I'm hoping I can go to the cardiologist that my father and brother go to, as he is very well versed in my father's condition. My father has been seeing him for many years now. However I don't know yet if he is covered on my insurance. Fingers crossed.
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Old 01-15-14, 02:31 PM   #7
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I know I'm slow on the bike. I rarely average more than 14.0 MPH moving on a ride, and have yet to break 15 MPH. Usually it's in the 12-13.x range. I routinely get out of breath and have to breathe really hard on some climbs, but isn't that normal? Trouble is, in nearly 2 years and well over 2,700 miles of riding, I haven't really gotten any better or faster. Before I was cycling, I was running and worked up from running 45s at a time to running for 30 minutes, but it was still very slow at 14:xx minutes per mile.
What's normal obviously varies from one person to the next. My "normal" pace is 17 mph average on an MTB set up for commuting, including slowing down for turns and transitions. My computer usually reads 18-19 mph on the flats. So by my standards, you are slow. At your age and with the time you have spent conditioning yourself, depending on the type of bike, you should be much faster if you are putting in a decent effort. So I would be concerned that your respiratory and circulatory systems are not performing very well.

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Old 01-15-14, 02:31 PM   #8
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Go see the cardiologist and let them do the tests they need to do. At your age, it is highly unlikely you'll have to alter your ilfestyle and they'll likely recommend you continue to ride the bike and get exercise. You may need to more aggressively control diet and weight and get on some preventative medications. You'll probably need to get regular cardio checkups for the rest of your life. But ask a lot of questions. The one I push hard for is that the doctor's need to justify in a fundamental way that the treatment they want me to undergo actually results in less disease/death, not just lower some arbitrary number like BP or cholesterol. A good doctor will give you lots of options and tradeoffs, not just tell you what you have to do.

The insurance thing is just a monumental hassle. I hate it, but it is the way the system works today.

Ultimately, we all are dealt a health risk hand when we're born and just have to play the cards we have - we can't get a re-deal. I have been very lucky with some things, but unlikely with others - for example, I'm likely going to have a lot of arthritis/joint issues in my later life. You do the best you can. Ignoring problems generally isn't a good strategy.

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Old 01-15-14, 02:33 PM   #9
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Sorry to hear it, but chin up, it's not doom. You don't say whether you have dilation or hypertrophy but anyhow you are not alone here. (That's my thread in Adaptive Cycling but you'll often find people in the 50+ forum going on about heart problems too.)

If you have HCM / HOCM then there's a lot of good resources online.
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Old 01-15-14, 03:17 PM   #10
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Yeah I'm hoping I can go to the cardiologist that my father and brother go to, as he is very well versed in my father's condition. My father has been seeing him for many years now. However I don't know yet if he is covered on my insurance. Fingers crossed.
Take out your insurance card and call that cardiologist office to see if they accept it. You could also go online/call your insurance and plug the cardiologist name in the Physician search tool, but you never know how up to date that info could be, whereas the Doc's office would know right off.
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Old 01-15-14, 04:05 PM   #11
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Yep, the cardiologist is in my insurance network, so that's good.

Darth, HOCM is exactly what my dad has. I think one of his heart valves was too small, causing the heart to have to work harder and become enlarged. They replaced that valve with the artificial one and put in the pacemaker about 10 years ago.

I'm hoping HOCM is not what I have. I haven't had nearly the problems with physical activity as he had when he was my age and into his 40's. He'll be 65 in September and is doing pretty well, though. They're about to move and build a house only about 4 miles from our house, and my dad said they might get bikes and could ride to our house, and us to theirs.

*edit* from what I have seen from recent Dr visits, my blood pressure is in good shape, I want to say around 120 over 60-something. My at-rest heart rate is usually in the 60's or maybe even a bit less while in bed. Before I lost the weight 2 years ago, my at-rest HR was usually in the 80's or above.

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Old 01-15-14, 04:52 PM   #12
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I hope you get some good news. Keeping you in my thoughts.
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Old 01-15-14, 07:27 PM   #13
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So I'll have to see a cardiologist soon. I pray he won't tell me to stop riding my bike or something like that, because frankly I just don't know if I can do that.
Bear in mind that there are several causes of an enlarged heart. The one you want to have is due to endurance exercise, and is a good thing.

Make sure your cardiologist knows how much you cycle (miles, frequency, and saddle time) and how hard you ride. This will help him or her determine if it's the good kind of enlargement, due to exercise.

You may need to get a heart rate monitor (HRM) and collect some data from your rides to help with any diagnosis.

My HRM numbers and very low resting heart rate convinced my docs that my enlarged heart is due to my cycling, and is a good thing. At my last birthday, I officially became the first male in three generations of both sides of my family to make it past 55 without an MI.

I average just over 5,000 miles a year, ride generally five days a week, and work it pretty hard when I'm out there (HR Zones 3 and 4 predominantly, with regular forays into Zone 5). My one-minute recovery rate is over 50 BPM. My resting rate is under 40 BPM. And did I mention I smoked for 35 years and have an arrhythmia?
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Old 01-15-14, 08:37 PM   #14
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Good luck! And as some one stated above, let the doctor know about the cycling.
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Old 01-16-14, 01:23 PM   #15
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hoping for the best dude. it does sound like it has affected your speed on a bike. but maybe that's just coming from a younger athletic dude. on my fixed gear my average is a couple mph faster than that, and I know I'm not that fast.

hopefully you can continue cycling, it shouldn't be about the speed anyways. it might hamper your ability to get super fit, but hopefully continue
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Old 01-16-14, 01:53 PM   #16
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Bear in mind that there are several causes of an enlarged heart. The one you want to have is due to endurance exercise, and is a good thing.

Make sure your cardiologist knows how much you cycle (miles, frequency, and saddle time) and how hard you ride. This will help him or her determine if it's the good kind of enlargement, due to exercise.

You may need to get a heart rate monitor (HRM) and collect some data from your rides to help with any diagnosis.

My HRM numbers and very low resting heart rate convinced my docs that my enlarged heart is due to my cycling, and is a good thing. At my last birthday, I officially became the first male in three generations of both sides of my family to make it past 55 without an MI.

I average just over 5,000 miles a year, ride generally five days a week, and work it pretty hard when I'm out there (HR Zones 3 and 4 predominantly, with regular forays into Zone 5). My one-minute recovery rate is over 50 BPM. My resting rate is under 40 BPM. And did I mention I smoked for 35 years and have an arrhythmia?
Resting 40 BPM dang! I didn't know it could be that low! I thought resting in the 60's was pretty good, especially since at one time it was in the 80's and higher regularly. A couple years ago I was laying bed one night and measured my HR as nearly 100 BPM!

I suppose I might try to pick up a HRM and get some data before I go see the cardio doc. My Dr office got me in March 10, which is pretty great as this particular guy is in high demand around here. My dad always raves about him.
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Old 01-18-14, 09:31 AM   #17
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Resting 40 BPM dang! I didn't know it could be that low! I thought resting in the 60's was pretty good, especially since at one time it was in the 80's and higher regularly. A couple years ago I was laying bed one night and measured my HR as nearly 100 BPM!
Yeah, didn't know that resting rate could be that low, but did know that runners could be measured in the 50's...
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Old 01-21-14, 06:58 PM   #18
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No, in high school my father was not able to participate in many of the physical activities in PE because of his condition. And because of not being able to be very active, he ended up being overweight, which I'm sure made it worse. He always had problems walking up much of any incline or steps, sometimes having to stop for a minute at the top of or even in the middle of single flight of steps. However he was never a smoker or drinker, so it really was all because of his heart condition. He took medication daily for decades before the pacemaker and artificial valve. I'm sure he still takes some now but not sure what.

My father actually did not get drafted for the Vietnam war because of his condition, something which I'm thankful for because I might not even be around if he had been sent over there.

I'm sure most of my weight issues are because my diet kind of sucks. I've also never had much issue going up inclines and steps. I may get a little out of breath every now and then but nothing major. So hopefully my condition won't be a big deal.
Hopefully, you're situation is significantly different.
Hopefully, you'll get different advice.

Good fortune.
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Old 01-21-14, 07:41 PM   #19
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Resting 40 BPM dang! I didn't know it could be that low!
I didn't either. It's funny how I found out. Back in April 2008, I'd been hig by a car earlier in teh day. Emergency was backed-up with an 8-10 wait time. I didn't feel seriously injured, so I declined teh amulance ride, and the cop drove me home. I made an appointment with my doc's offic. It's a pretty large clinic so you can almost always get in--especially if you have a case number to bill against for a motor vehicle accident.

Without health insurance (until Obamacare) I can go years between doctor visits. It had been five years since my last visit. At that time, I was a sedentary smoker.

Anyway, about two hours after the crash, the nurse took my vitals. She checked, checked again, then playfully rapped me on the side of the head saying, "Are you conscious in there?" My HR was 42, and BP 97/62.

She looked at my chart and asked, "How did you do that?"

"I finally started doing what you folks have been telling me to do all these years. Who knew that it actually works?"

Since then, I've used my bike's HRM to measure a 38 in bed before getting up.
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Old 01-22-14, 09:16 PM   #20
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See the cardiologist and see what he has to say. I have an enlarged heart and the cardiologist I saw basically said there was nothing to be concerned about.
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Old 01-23-14, 09:42 AM   #21
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See the cardiologist and see what he has to say. I have an enlarged heart and the cardiologist I saw basically said there was nothing to be concerned about.
Well that's good to know, thanks. Did he say what may have caused your condition, or what specific condition it is within the realm of "cardiomegaly" (enlarged heart)?
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Old 01-23-14, 12:47 PM   #22
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I'd be really surprised if you were told to stay off the bike. Biking seems to be the go-to exercise for those that aren't supposed to thrash on their bodies anymore.

Keeping you in prayers
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Old 01-24-14, 08:33 PM   #23
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See the cardiologist and see what he has to say. I have an enlarged heart and the cardiologist I saw basically said there was nothing to be concerned about.
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Well that's good to know, thanks. Did he say what may have caused your condition, or what specific condition it is within the realm of "cardiomegaly" (enlarged heart)?
It may be something genetic. Both my brothers and my sister also have enlarged hearts. So does my father and several of my cousins on his side of the family. Also understand, these are only mild enlargements, not enough to bother us in day to day living.
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Old 01-24-14, 09:00 PM   #24
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Don't take this lightly...

On the extream end I have seen a few outwardly appearing competative athlets succum (die) of this condition...

If its real its going to take allot of training and control to stay fit...

I have seen this conditon worse in competitive weight lifters using "The Juice" or similar agents...

Look for a cardiologet who rides and listen to what he says...

You can change your life to accommodate this condition and still have a fun life...
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Old 03-26-14, 11:22 AM   #25
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So I guess I should update this. I finally got in to see the cardiologist who my dad and brother also go to. This guy is VERY familiar with my dad's condition and history, and has been telling him for some years that he wanted me to come to have a look at things. Well I finally got in a couple of weeks ago.

His assessment is that I do in fact have HOCM, just as my father does. However my condition isn't nearly as bad. He did not prescribe any medication, and (thankfully) no surgery. He didn't even say I had to cut back on my activity and in fact said the cycling is probably good for me. He just said he wants me to come back once a year so they can check up on things.

I'm going back to his office in a couple of weeks for another ultrasound "echo" test, just because my first one was done at my regular Dr office, and sent to another cardiologist in another town. So he wants one done there in his office just in case.

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.
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