heart enlargement in wieghtlifters

[Steve Kirit]

I know this is an off the wall topic but is anyone familiar with or have had an echocardiogram test? This is the test where they rub the metal probe on your chest while looking at sonic images of the heart. if you had the test or know anyone who has what did the doc tell them about aortic root anlargement? Apparently this is the part of the heart that can dilate in guys who lift heavy weights because of the strain the extremely high bp puts on the heart. The doc told me my "aortic root" was on the very high end of normal possibly enlarged a bit (no doubt from 16 yrs of hard training) but also I am the only "strength oriented patient" he has, so I am just putting this out there to see if anyone else by some chance has had a similiar experience.
thanks,
steve

http://health.mweb.co.za/fitness/Lifestages/16-480-2425,25714.asp

[Steve Kirit]

...........................................

[Ryan Bakke]

well i guess its a good thing stone lifitng does not raise your blood pressure! :BB:

this has been a big issue recently with basketball players. many already had the condition as the article said. hell it took john ritter and he lifted only a bit more than soup cans and milk cartons i am sure.

everything i have read, most of it by Dr hatfield (not a cardiologist) has said the enlagement of the weightlifters heart is a healthy one and shouldnt be sweated.

"I am the only "strength oriented patient" he has".

its always hard to filter through this kind of stuff because most doctors dont squat/deadlift/stonelift/olympis lift etc.

good read though Steve, Thx

[Garrick Daft]

I kinda don't know what to say Steve Kirit...I feel for you, but I don't know anything about this medical issue. It's always been told to me though that heart enlargement from excessive training is common though. What happened to Jon Pall, was his do to the same issue? Hope everything goes well for you.

[Brian Schoonveld]

Steve, Call Me as soon as you see this Brian Schoonveld

[ClayEdgin]

I'm just thinking out loud here, but because the heart is a muscle it would seem reasonable that it could grow to keep up with the demands of a guy who trains hard. Lance Armstrong is said to have an abnormally large heart as well.

[Tony Christopher]

I'm not going to offer an opinion without knowing your history or the results of your tests.

But there are two basic issues here.

First, people who are carrying huge amounts of muscle mass typically have some degree of hypertension (elevated blood pressure). The reason is simple, all of that muscle has to be oxegenated. To accomplish this, the heart has to pump harder than it would for a "normal" individual. In mesomorphs who are less than 300 pounds lean, this is seldom an issue. Above this, it becomes an increasing risk, especially for someone who has some other kind of congenital abnormality.

Second, when someone is actually lifting very heavy weights, blood pressure rises (for obvious reasons). This is what causes nose bleeds in people who are squatting and deadlifting (most commonly).

I'm sure you already knew that.

Now, obviously, these problems work in conjunction with one another. If someone who's blood pressure is already high, attempts a heavy lift (driving the pressure even higher) AND he has a weakness in the aorta (or elsewhere) there's the potential for catastrophic failure like a dissection.

Are these significant worries for you? Generally, if your doctor found no other abnormalities, probably not (from what I've seen of you on television you're not extremely large ... right around 300 pounds). However, for peace of mind, I always recommend people get a second opinion. Try to find a cardiologist who specializes in sports medicine and have him or her revalute you. You'll sleep better at night.

Regards,

Tony

[Steve Kirit]

Thanks for all the great responses...Tony...I go about 280 these days, resting bp usually 130/78

My aortic root was measured at 3.9 then 4.0 centimeters. The cardiologist instantly said my strongman days are over and that i shouldnt lift weights. I always knew there would come a time when i needed to cut back down to my normal 230-250 range, but i never imagined not being able to lift a weight.

[JEFF VANCO]

Hey Steve, about 2 months ago I had one of those done.

I was using the supplement No-Xplode for a week and started to experience periods of shortness of breath, heart palpitations, and dizziness. I stopped using it and was still experiencing some negative effects. I went to the hospital and 20 min later I was in a bed with electrodes all over my chest. They tested my heart, kidneys, blood, and lungs.

Apparently the l-arginine had a negative effect on my body.

Anyhow, I asked the doctor about training and he told me powerlifting and Olympic lifting is good for the heart because it's such hard work both anaerobic and aerobically.

He told me to keep training, dieting and doing my cardio.

At 270lbs at the time, I had a resting heart rate of 64 beats per minute, which is pretty good.

I tell you, it's not fun being alone in a hospital awaiting bad news. You sure appreciate life when the news is good and you are released.

[Jonathan Macfarlane]

Thanks for all the great responses...Tony...I go about 280 these days, resting bp usually 130/78

My aortic root was measured at 3.9 then 4.0 centimeters. The cardiologist instantly said my strongman days are over and that i shouldnt lift weights. I always knew there would come a time when i needed to cut back down to my normal 230-250 range, but i never imagined not being able to lift a weight.

Get a second opinion IMO.

[davebeers]

i would also so get a second opinion. I have heard of heart enlargement before but never as a result of weight lifting.
The only heart condition i have heard related to weigthlifting has been aneurisms....typically of the aortic type. The theory is that the peaks of high blood pressure during weightlifting cause the aorta to get weak, balloon out, and eventually burst.

Chronic high blood pressure is the leading cause of heart enlargement. Lets not forget the heart is a muscle and having to push against increasing resistance over time would cause it to thicken.
Growth Hormone has also been linked to thickening of the heart.

[Steve Pulcinella]

Hey Kirit, not to downplay the seriousness of anybody's health issue but why is it that everytime any athlete goes to a doctor they always try to tell us to quit lifting weights and that we'll never compete again? It seems to me that it's always the stock answer they give you because it's the easiest answer for them to give. If you think about it they can't give you any other answer, if he told you to go out and pull a truck tomorrow and god forbid you died he would be liable. I just get frustrated by the medical community sometimes.

[Jesse Snadden]

Your resting blood pressure is excellent. Have your blood lipids checked out and get a second opinion (preferable from someone who has dealt with an athlete like you before). I don't see how lifting weights can be an unhealthy thing. I believe it is normal for athletes to have a slightly enlarged heart.

[DaneGarreau]

Steve P., Your exactly right. It isn't just athletes they give stock answers to. If an old lady complained of back pain when she sweeps the floor, they will just tell her to stop sweeping the floor. Great information for a $20 copay. It gets people in and out, without having to do any work.

I suggest for everyone to see sports doctors whenever they have a problem.

[davebeers]

Steve P., Your exactly right. It isn't just athletes they give stock answers to. If an old lady complained of back pain when she sweeps the floor, they will just tell her to stop sweeping the floor. Great information for a $20 copay. It gets people in and out, without having to do any work.

I suggest for everyone to see sports doctors whenever they have a problem.
well in the medical field there is a huge movement to CYA(cover your ass) With all the lawsuits going around you'd be risking your job not to.

As an emt if someone is sick and refuses to be transported i have to advise them of all the possible repercussions of not going to the hospital. I have to make sure i ask them 3 times....3 times!!! That's rediculous IMO! Then i have to fully document that i asked them 3x and they said no, also documenting that they were in sound mind to make a rational decision.


People are sue happy today. If Steve died from a heart related incident and his doctor had not told him to not lift weights(and fully document it), then his family could sue for millions

[Tony Christopher]

Don't be too hard on the medical community.

Liability is a legitimate concern, especially for folks in high risk specialties like cardiology (if a GP misdiagnoses a hangnail, and someone develops an infection in their foot, it's not the end of the world ... but misdiagnose a heart condition and the consequences can obviously be devastating). Unfortunately, we live in a highly litigious society where people expect physicians to be infallible and sue whenever they fail to live up to that standard. You wouldn't believe what some of my friends pay in yearly liability premiums!

So I recommend this (to Steve and anyone else), when you go for a second opinion (or first opinion for that matter) instead of asking the doctor to "OK" your lifting (which he or she will be very reluctant to do) ask him or her to assess your risk.

In other words, when the Doc says "You have condition X ... I'd recommend you stop lifting!" follow up with:

"Well Doc, can you tell me how much condition X increases my risk over someone who doesn't have it? Are we talking a 10% additional risk of of a dissection? 50%? 500%? Also, is there anything I can do to offset / manage the risk condition X brings?"

This way the doctor can put in his or her notes that he / she informed you of the additional risks, while at the same time giving you get the information you need to decide whether or not you can continue to train, compete, or whether you can modify your lifestyle in some functional way.

Additionally, you're testing your doctor's knowledge this way ... if he or she can't (or won't) give you a straight answer, that's the sign to look for a different doctor.

[Steve Kirit]

i would also so get a second opinion. I have heard of heart enlargement before but never as a result of weight lifting.
The only heart condition i have heard related to weigthlifting has been aneurisms....typically of the aortic type. The theory is that the peaks of high blood pressure during weightlifting cause the aorta to get weak, balloon out, and eventually burst.

Chronic high blood pressure is the leading cause of heart enlargement. Lets not forget the heart is a muscle and having to push against increasing resistance over time would cause it to thicken.
Growth Hormone has also been linked to thickening of the heart.

thanks again everyone...yes Dave, thats the issue, my heart size itself is fine, the aorta is dilated supposedly putting it at risk for dissection, which of course equals death in most cases. The thing is I can't find a lot of data on any tests done on weightlifters, meaning if our aorta thickens in a somewhat safer way than the typical "bulge" type anneursym. At 4.0 the "high normal" measurements are around 3.8-3.9

[Eric Johnson]

Sorry to hear about that, I hope it turns out OK.

I imagine the problem you would find with any kind of data on weightlifters with heart problems would be you would never know if the condition was a result of weights or suplementation or genetic. Since it seems like it would be a long term effect (if at all) a controlled study would be practically impossible to conduct with any kind of accuracy.

[Daniel Leib]

I went to an undergraduate exercise science program in PA that was pretty focused in cardiac issues/rehabilitation and compete myself (just to give you some background Steve).

I've done a lot of reading on resistance training and heart health and recently completed a study on the subject (it was on blood lipids and work capacity, though, so not immediately applicable here), and I have to tell you that the research that has been done in this area is pretty sketchy at best. There have been a number of of studies on CHF patients and resistance training that show benefit, but the protocols used were all relatively light for your typical strongman (12-15 rep range). There have also been some issues noted with arterial compliance (how flexible the arterial tissue is) and that the tissue tends to become more rigid with heavy training. This can be a bad thing since rigid tissues tend to rupture more easily.

It's hard to tell if you're ACTUALLY at risk without seeing the picture - you mentioned that your aorta was measured at 4.0 Is that the total diameter of the vessel or just the opening? Was the picture interpreted correctly? A key issue here would be not just whether the opening is dilated, but also if the surrounding arterial tissue has hypertrophied as well to account for increased pressures. If you're not confident that the tech who did the test is fully aware of what he or she is seeing, it'd be best to hold off on the heavy training and see a specialist at a well respected hospital.

Did you get the test done at UPMC? Who actually ran the test? I know a few of the people out there and could vouch for their expertise.

Just as an FYI, the heart enlargement being dangerous thing was debunked in the scientific community about 20 years ago. If a doctor ever tells you that the myocardial hypertrophy associated with resistance training is dangerous, find a new doctor as they're WAY behind.

Also just as a general statement, all of this stuff goes out the window if performance enhancing substances are used. Stone and Fleck have made particular note of this in their research and it's one of the reasons research done on elite strength athletes is all but useless (since none will admit to use, but obviously many do). A lot more dangerous maladaptations do occur in those circumstances.

Also a side note, the show you ran at the Kumite Classic this past weekend was great. I just wish I could have heard about it a bit earlier and you would have had another 200lbs competitor.

-Dan

[Steve Kirit]

Thanks Dan, We hope to make the show even bigger and better next year.

Ive always had borderline bp...at WSM in '04 I was 130/80 the morning right before the comp began. I got thetest done at Allegheny General, one of the best cardiac places supposedly around. The measurement was taken at the aortic root. From what I understand, enlargement to the aorta does not reverse itself. On my stress test my bp topped at 155/95 at 165 BPM, and my choletorel was 183...interesting i had cholestorel checked 5 months back and it was 156, I had been eating pretty bad though that week. My triglycerides were 140... everything else liver kidneys glucose was perfect. I think i am going to try to get an opinion from someone who specializes in Athlete's heart, if there is such a person around. (I was the youngest person in the cardio office by about 30 years) My dad had high BP since he was 25...my grandmother had an annyeurism repaired on her heart at 71. Guess i shouldnt have been training so hard all these years. Kinda sucks that trying to better yourself and doing things the right way ends up potentially hurting and or kiling you. Thanks for all the great input from everyone who's posted on this thread.

Steve

[Garrick Daft]

Steve (hope don't mind using your first name), hope everything goes well. You have been the man...and had a great career.

Are you officially retiring?

[davebeers]

ok...now that you've confirmed that you have an aortic baloon that changes everything. Your doctor was completely right when he told you not to lift.
For guys that don't know what steve has is a balooning of the main artery coming from your heart. This artery is typically the size of your finger....if it ruptures most people bleed out in a matter of 10-20 mintues. The survival rate for aortic anneurisms is .01%...then again my friend dave lieb survived one 6 months ago and is training again today.

Steve, did your doctor discuss any options with you? If he didn't offer surgery to fix the condition i think you should find another doctor. All it takes is a spike in your blood pressure such as getting angry and straining for that aorta to rupture, if i were you i wouldn't want to be playing the waiting game.
Good luck man.

[Tony Christopher]

It's still not clear to me, based on the description, exactly what Steve's diagnosis is.

If his Aortic root measurement is merely on the high side of normal, that's really a very different diagnosis from having an aneurysm.

That's why I think a second opinion is absolutely essential in this case.

Clearly, it would be a tragedy to lose one's life by continuing to train when one's condition presents unacceptable risks.

On the other hand, it would also be a tragedy (albeit a smaller one) to abandon a lifetime of training if it really isn't necessary. Weight training brings so many other health benefits.

Get a second opinion from a cardiologist that has experience with althetes.

[Declan Mac Daid]

I would go get a second opinion. What have you got to loose? This is your health and I don't think you can mess with that.

"Doctors differ and patients die......"


Dec

[Daniel Leib]

Thanks Dan, We hope to make the show even bigger and better next year.

Ive always had borderline bp...at WSM in '04 I was 130/80 the morning right before the comp began. I got thetest done at Allegheny General, one of the best cardiac places supposedly around. The measurement was taken at the aortic root. From what I understand, enlargement to the aorta does not reverse itself. On my stress test my bp topped at 155/95 at 165 BPM, and my choletorel was 183...interesting i had cholestorel checked 5 months back and it was 156, I had been eating pretty bad though that week. My triglycerides were 140... everything else liver kidneys glucose was perfect. I think i am going to try to get an opinion from someone who specializes in Athlete's heart, if there is such a person around. (I was the youngest person in the cardio office by about 30 years) My dad had high BP since he was 25...my grandmother had an annyeurism repaired on her heart at 71. Guess i shouldnt have been training so hard all these years. Kinda sucks that trying to better yourself and doing things the right way ends up potentially hurting and or kiling you. Thanks for all the great input from everyone who's posted on this thread.

Steve

The people over at Allegheny do know their stuff, so I'd at least believe the diagnosis for now. I don't really know who specializes in athletes and heart conditions these days. You may email Dr. Zatsiorsky at Penn State since he's dealt with so many lifters over the years or maybe Dr. Eric Stone, he recently had a heart attack and rehabed himself using resistance training. I'm not sure where he is right now.

Best,

Dan

[Mike Westerling]

..I'm sorry to hear about this. I hope and pray your second opinion turns out more favorable. Please let us know how it turns out.
-Mike

[Ben Booker]

I kinda don't know what to say Steve Kirit...I feel for you, but I don't know anything about this medical issue. It's always been told to me though that heart enlargement from excessive training is common though. What happened to Jon Pall, was his do to the same issue? Hope everything goes well for you.

I also hope everything goes well for you Steve.

I would get a second opinion. I don't know to much about the heart in the specifics metioned.

I think that Jon Pal S. had a serious genetic heart condition in his family. I read this in wikipedia. I am not sure if it was the same thing that Steve is talking about, but from what I read there it sounds like it was something he was aware of all of his life because relatives of his might of had the same thing with similar results?