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Question:

Are my chest aches age-related and should I be more concerned about mild thickening of heart muscle and MVP?

Hello. I recently visited a cardiologist due to experiencing left-sided chest aches. . . (I underwent a nuclear stress test in 2010 which came back normal) . . . This time (two weeks ago), I was given yet another nuclear stress test and an echo. Went back to the doc and received what I perceived as good news/not so good news. Normal nuclear stress test, and “Moderate thickening of the heart muscle". That is all I remember, unfortunately, but if I understand correctly this is called Hypertrophic Cardiomyopathy, correct? Anyway, I am a 41 year old white male, no diabetes, no kidney issues, and take Lisinopril and Cardizem. Doc says he wants to see me a couple of times a year for BP/weight check (I’m kind of a big guy). Question is: Do I need to freak out about this? Or is this something that comes with age etc? Oh...He also said I had mitral valve prolapse. I was told that there were no restrictions with regard to physical activity and to see him every six months. Thoughts? 

submitted by Scott from San Antonio, Texas on 3/14/2013

Answer:

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

Michael J. Mihalick, MDDear Scott, Your chest pain is what we cardilogists call 'atypical chest pain' meaning that is not like the 'typical' chest discomfort that occurs from heart disease. It may be originating from the chest wall or another non cardiac source. The two normal nuclear stress tests are very reassuring that it is not due to a blocked or narrowed coronary artery. This type of chest pain can be associated with mitral valve prolapse. The 'moderate thickening' of the chest wall is another matter. The most common cause is high blood pressure. This is why your doctor recommended monitoring your pressure to see if you need blood pressure medication. Individuals who lift weights and highly trained atheletes can also have thickened  heart walls. When the thickening is due to athletic activity, it will regress when the individual stops training. When due to high blood pressure, it indicates that the average pressure is high enough to warrant medication. Another cause is 'hypertrophic cardiomyopathy'. These individuals frequently have a family history of heart disease or heart failure. Finally, this could be a normal finding in a very large individual. Periodic followup is the best way to determine the cause of the hypertrophy (thickened heart wall). Mitral prolapse per se is not associated with hypertrophy, and in the vast majority of cases is a benign condition. I agree with your cardiologist's recommendations.  

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Updated March 2013
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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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