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Question:

Is moderate exercise beneficial for thickened heart muscle?

I have what my doc said is "slightly thickened heart muscle" with a measurement of 1.4 mm. Absolutely everything else about my heart looked good except that a week of monitoring showed a single incident of tachycardia (this is sometimes bothersome when I'm at rest, never when active). The doctor gave me a beta blocker to try to reduce it, but I didn't tolerate it well. I don't want to deal with this with medication. I want to rely on lifestyle changes. I am following a vegan diet (not exactly Ornish as I'm including nuts and small amounts of Canola oil). My question is exercise. At 54, I still tend to overexert and have a hard time keeping my heart rate in the target zone. Is moderate exercise beneficial for thickened heart muscle? Will weight training keep the muscle thick? Does caffeine contribute to this condition? The doctor has no idea if the tachycardia is related to the muscle thickness. Is there any reason for me to be concerned? 

submitted by Mickey from Austin, Texas on 4/21/2011

Answer:

by Texas Heart Institute cardiologist, Michael J. Mihalick, MD  

Michael J. Mihalick, MDDear Mickey, I assume the only abnormality noted on the echocardiogram was the slightly thickened left ventricular wall (mild concentric hypertrophy). This is primarily seen in two situations: hypertension and power lifting. The latter would include anyone who is highly trained and uses weights. When the training is cut back or stopped, the thickening (hypertrophy) regresses. It is a normal response of the heart to stress which includes vigorous exercise. From your letter I imagine you fit into this category. In patients who do not exercise vigorously, the hypertrophy is usually due to hypertension, and is an indication for treatment. Just as your skeletal muscles enlarge in response to weight training, the heart muscle responds in a similar fashion by enlarging and thickening. This is a normal adaptation that allows your heart to provide the increased output more efficiently and with less stress. Caffeine does not affect this process and is often used effectively by long distance runners. You diet should be well balanced with plenty of high quality protein and fiber. Unless you are training for a marathon or triathelon which requires more carbohydrate,  you should try to eat carbs with a low glycemic index. The nutritional requirements of extreme sports are quite different from what is recommended for normal intake. There are mixtures for nutrition while running a marathon and immediately after. I recommend that you check with a nutritionist before consuming any of the high protein drinks frequently recommended to body builders. Some have been found to be potentially harmful. The spontaneous tachycardias may be triggered by the adrenaline which is released during exercise. You may have an inherited tendency for this to occur. Individuals that are highy trained may develop 'athelete's heart' which is cardiac enlargement related to chronic exercise. This sometimes is the cause of arrhythmias. The prognosis is good if there is no other structural problem with the heart. If the tachycardias become a problem, your cardiologist will know how to best evaluate them. Sincerely. 

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Updated April 2011
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Texas Heart Institute Heart Information Center
Through this community outreach program, staff members of the Texas Heart Institute (THI) provide educational information related to the prevention, diagnosis, and treatment of cardiovascular disease. It is not the intention of THI to provide specific medical advice, but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided and THI urges you to visit a qualified physician for diagnosis and for answers to your questions.
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