Metaphorically, of course, it’s great if someone says you’ve got a large heart. Medically, apparently it’s more ambiguous.
A few years ago, as a result of an employment health exam I was told that my heart was too large and that’s a bad condition. Naturally, upon receiving such news I began googling and learned that a large heart can be a serious problem. . . or it can be a sign that one is athletic. Many top athletes, not surprisingly, have large, muscular hearts that work better than those of us mere mortals.
Anyway, I forgot about the whole subject until yesterday, when I received results of my latest employment health exam and was again told I have a large heart. So, again I’m wondering, does that mean I’m in trouble or does it mean the exact opposite, that my heart is better than normal? Incidentally, they also noticed a heart echo, which they also seemed concerned about.
Here’s what others say on the subject.
[quote]Cardiomegaly is a medical condition wherein the heart is enlarged. It is generally categorized in the following manner:
Cardiomegaly due to dilation
Cardiomegaly due to ventricular hypertrophy
Left ventricular hypertrophy (LVH)
Right ventricular hypertrophy (RVH)
Left atrial enlargement
It is not always negative; athletes often have enlarged hearts. However, it can often be associated with other serious medical conditions. . .[/quote]
[quote]CARDIAC CONDITIONS AFFECTING ATHLETES
. . . only in the past two decades has the application of echocardiography and other noninvasive imaging techniques permitted definition with some precision of the alterations in cardiac dimensions associated with athletic conditioning.
The athlete’s heart reflects a normal physiologic response to exercise. However, the constellation of findings on physical examination. . . of a well trained athlete can occur in certain pathological cardiac conditions, which may result in misdiagnosis and mislabeling of otherwise healthy individuals. Athletes can certainly have cardiovascular disease. Distinguishing between non-pathological changes in cardiac morphology associated with training (athlete’s heart) and certain cardiac diseases with the potential for sudden death is an important and not uncommon clinical problem.
. . . when a long-term demand is imposed on the heart, pump function is maintained by means of cardiac adaptive responses. . . increasing septal and free-wall thickness to normalize myocardial wall stress (La Place’s law). When chronic volume overload occurs, left ventricular end-diastolic diameter increases, with a proportional increase in septal and free-wall thickness to normalize wall stress. The increase in the diameter and in ventricular wall thickness can be considered appropriate compensation for the chronic volume overload placed on the hearts of athletes, who require sustained increases in cardiac output during competition.
In a well-trained athlete, the constraints due to La Place’s law may be compensated for by increasing myocardial mass. A larger myocardial mass reduces the cardiac wall tension required for cardiac ejection. An athlete in need of a high capacity for oxygen transport benefits from a large stroke volume, a low heart rate, and a thickened ventricular wall. Thus, the changes in cardiac dimensions that occur with training result in an increased efficiency of cardiac performance.
Athletes often have a slow resting heart rate, a third and fourth heart sound may be present as well as a systolic murmur. The resting ECG more frequently shows variations from the accepted normal (Table 1) and Holter monitoring more frequently picks up various rhythm disturbances than in age matched controls (Table 2). . .[/quote]
I’m no Lance Armstrong. I’m not even an athlete anymore, but for many years until about a decade ago I did a fairly substantial amount of running, cycling and other intense aerobic activities, and I try to keep up with them from time to time. So I wonder if those activities way back then may have enlarged my heart and through basic aerobic maintenance over the years it’s remained slightly large, in a healthy athletic way, or is that possibility very remote and more likely it’s bad news.
I know, few of you are medical experts and I really ought to get the opinion of a competent doctor back in the States, which I intend to do some day. But I’m just curious if anyone is at all familiar with these issues.