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Dr .Saeed ahmed
Dr .Saeed ahmed, Doctor
Category: Cardiology
Satisfied Customers: 4448
Experience:  MBBS/FCPS(R)/MRCP U.K(R), Senior Registrar Cardiology
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Hi a quick question about an echocardiogram I had today, I

Customer Question

Hi a quick question about an echocardiogram I had today, I have not had the full results from the Dr but i asked the technician about the thickness and was told that the septum was slightly thicker than normal .. It's approx 1.4cm - 1.5cm .. I had a similar test 4 years ago and at that time it was 0.9cm . The only changes in my life in the last year or 2 have been that I've been going to the gym more regular and have packed on more muscle on my body.. Could this have affected my heart? Optional Information: Person's Gender: MalePerson's Age: 39
Submitted: 2 years ago.
Category: Cardiology
Expert:  Dr .Saeed ahmed replied 2 years ago.
Customer:

Hello, Thank you for your question. I will try my best to help you with your questions.

Customer:

High blood pressure and high endurance exercises are main cause of septal hypertrophy.

Customer:

If you were doing body building or high endurance exercises then it is a normal response that heart muscles including the septum will thicken.

Customer:

This is very normal.

Customer:

Let me know if you have questions

JACUSTOMER-uwvyursb- : So it's not something that will cause sudden death? I've been reading and sudden seath seems to be something that's associated with it
Customer:

no

Customer:

sudden death is a risk which increases when your septum approaches around 30mm

Customer:

1.5 is a borderline thickness

Customer:

and does not increase the chance of sudden death

JACUSTOMER-uwvyursb- : 2 mins.. Someone is. At the door
JACUSTOMER-uwvyursb- : I have read that excercise/weight training thickens the left ventricle?? Not the septum? Also one of the other docs here told me that excercise would not be the reason behind it.. So what's true and what is not?
Customer:

It is totally incorrect... Septum is the first part that thickens in case of high endurance exercise.

JACUSTOMER-uwvyursb- : :-)
Customer:

It is only because of this reason we use septum as a land mark for testing HCM or hypertrophic cardiomyopathy

Customer:

against athletes heart.

JACUSTOMER-uwvyursb- : Oh man I was in such a panic that I didn't go to work today thinking that I could die sudden.. I have been more gym focussed in the last 1 year and do weight training but not excessively .. I have put on some muscle mass but I'm just average looking because I was skinny before.. So u reckon I will be ok? Is it reversible?
Customer:

Yes it is reversible.

JACUSTOMER-uwvyursb- : Is it reversible if I stop training? Or should I continue trainjng?
Customer:

reversible if you stop training for 6 months and then go for echo again

Customer:

it will show less thickness

Customer:

and then you can continue with your exercise because this will be a proof that it is athletes heart.

JACUSTOMER-uwvyursb- : Ok but if I continue training then am I at risk ?
Customer:

1.5cm thickness is not a risk, you are at low risk of sudden death.

Customer:

risk arises when your thickness is around 30mm or 3 cm

Customer:

you can continue exercise as you are not at risk

JACUSTOMER-uwvyursb- : Should I carry on as normal? Go back to work?
Customer:

i just mentioned the protocol for stopping exercise and getting echo to help you understand how we differentiate HCM and athletes heart

Customer:

you can continue as normal

Customer:

there is no risk at all.

JACUSTOMER-uwvyursb- : Will my cardiologist agree with everything u have told me?
Customer:

yes, because i am a cardiologist and this is a world over protocol that we do everywhere in such cases.

Customer:

I hope this answers your questions,

JACUSTOMER-uwvyursb- : Oh so it's perfectly ok to have an athletes heart? I always thought that an athletes heart would be someone who is a professional football player etc and not just an ever she Guy like me who goes to the gym
JACUSTOMER-uwvyursb- : What times do u be online if I need to come back to u?
JACUSTOMER-uwvyursb- : Meant to say average guy
Customer:

It is true

Customer:

athletes heart is a heart of high endurance exercising person.

Customer:

In your case it is just 1.5cm which is not thick at all as compared to HCM or athletes heart

Customer:

So no risk in your case

JACUSTOMER-uwvyursb- : So me going and doing weights 3 times a week is classed as high endurance?
Customer:

Yes it is

JACUSTOMER-uwvyursb- : In the UK they say 1.2cm is the normal limit
Customer:

I have to pick my kids from school see you after few hours.

Customer:

Yes it is same all over 1.2-.1.3 cms

Customer:

bye for now will see your reply after picking up kids from school.

JACUSTOMER-uwvyursb- : Ok thanks for the advice
Customer:

you are welcome.

Customer:

Do rate my answer to credit the reply. Have a nice day.

Customer:

You can always come back in our cardiology section and ask questions

JACUSTOMER-uwvyursb- : Ok .. Are u UK based?
Customer:

or ask by direct request for S.A.Alam

Customer:

I have degrees from UK.. but not basically from UK

JACUSTOMER-uwvyursb- : I was just thinking of the time difference.. When are u best to get hold of?
Customer:

What is time at your place ?

Customer:

Is it 10:10 am at your place or time zone ?

JACUSTOMER-uwvyursb- : It's 10:10am
Customer:

From your time zone it would say best time to find me is from 3:00 pm to 7 pm

Customer:

It do come online before that like 10 am in your time zone

Customer:

but just to check mail

JACUSTOMER-uwvyursb- : Ok brilliant I will bear that in mind.. Ok just to finish off .. 1. My septal thickness is a normal occurrence with some who weight trains.. 2) is not thick enough to cause sudden cardiac arrest or any arrythimias? 3. I should not worry at all about it being the thickness it is?
Customer:

1... It is correct.

Customer:

2... It is correct

Customer:

3... It is correct.

JACUSTOMER-uwvyursb- : Lol ok
Customer:

I hope this answers your questions.

Customer:

Do rate my answer if no further questions at this time. Have a nice day.

JACUSTOMER-uwvyursb- : Thanks for everything it has calmed me a lot.. Have a nice day ..khuda Hafiz
Customer:

Allah Hafiz...

Customer:

It was my pleasure to help you out.

Dr .Saeed ahmed, Doctor
Category: Cardiology
Satisfied Customers: 4448
Experience: MBBS/FCPS(R)/MRCP U.K(R), Senior Registrar Cardiology
Dr .Saeed ahmed and other Cardiology Specialists are ready to help you
Customer: replied 2 years ago.
Hello again .. Another Dr has said the following:
Dr. K. :
I do not think that thickness is necessarily "normal" As I mentioned above, it may be normal if it is the only abnormal finding. I am wondering why you have a cardiologist and are getting an echo if you are healthy. That is why I asked if they are screening you for hypertrophic cardiomyopathy. About 1:500 men may have it.
Dr. K. :
I am also hoping that you will listen to the advice of your own cardiologist
Customer: Oh sorry I forgot to answer that part of your question.. I went to the cardiologist just to have a check up because I've got into fitness in the last year or so and just wanted to make sure my heart was healthy.. I don't have any symptoms of any sort at all
Dr. K. :
I wonder why a cardiologist who order an echo at all for that reason. Its not really indicated. Is that why you had the first one?
Dr. K. :
And why did you have the second echo? If you had no symptoms why was it ordered?
Dr. K. :
It sounds like maybe you were pressing for testing that did not really need to be done and then this was found.
Customer: I had it done privately so paid for it.. I have a treadmill test next week.. The first one in 2010 was because of an abnormal ECG finding .. But it turned out that it was nothing
Dr. K. :
What was the abnormal ecg finding
Dr. K. :
So then you have to remember that the echocardiogram is not a screening test
Dr. K. :
You can be tested for the genetic mutations associated with hypertrophic cardiomyopathy
Customer: They thought that it might be brugada because of the ECG so i had a 24 hour ECG done too at the time which was normal.. Since then I had had that original suspect ECG checked by my cardiologist now and he says it never was an indicator for brugada
Dr. K. :
Ok so no reason for the first echo really, after the fact.
Customer: It was said it was just an artefact in the ECG?
Customer: Is the genetic mutations test a simple blood test?
Dr. K. :
That makes sense. It could be someone with less experience reading it.
Dr. K. :
No its not a simple blood test
Dr. K. :
Not every lab does it
Customer: Ok I will enquire about it
Dr. K. :
transgenomic.com
Dr. K. :
Thats where you order the test
Customer: So with me not having any symptoms and with it just being borderline thickness would u say I'm ok?
Customer: I'm in the UK will they do it here?
Dr. K. :
No they wont You get the kit yourself, and pay for it.
Dr. K. :
I think first consult with your cardiologist and see what he thinks. You are asking me what to do to know that you are ok, those are my thoughts
Dr. K. :
Much of what I know about this is from personal experience. My son went through something similar. He is a track athlete and had cardiac issues and a similar echo. We did all the testing including thru transgenomic.
Dr. K. :
I know how you feel because I wanted to know that he would be ok to keep working out. :)
Customer: Thanks for sharing that with me .. I appreciate it.. Is he ok?
Dr. K. :
Yes, he is.
Dr. K. :
spent a good amount of money privately, as you did. But have peace of mind.
Customer: That's good.. I'm on that site now.. Am I looking for HCM?
Dr. K. :
Yes
Customer: Actually I'll look for a UK site who do the test
Dr. K. :
Thats fine, thats just the one I know here, they may have a UK site
Customer: So if the test comes back normal then does that mean I don't have hcm? What if I stopped training for 6 months and the thickness went to normal levels.. Would that not be proof that it's not anything to worry about?
Dr. K. :
Most likely
Dr. K. :
And yes,
Dr. K. :
Though I doubt it will shrink down in 6 months
Customer: I think I might try the latter
Dr. K. :
http://www.transgenomic.com/labs/cardiology/familion/hcm
Dr. K. :
Heres the link to the test
Dr. K. :
Ok and good luck, hope all goes well
Customer: Thanks
Expert:  Dr .Saeed ahmed replied 2 years ago.
I would keep it simple... Risk of sudden death increases when septum is more than 30mm... Before this value there is no concern, you have borderline increased thickness and it is simply due to your exercise. In case of HCM septum enlarges abnormally and irregularly which is not present in your case.
So in my opinion you are safe with no risk of sudden death.
If you are over concerned on this issue then you can try my initial suggestion to stop exercise for 6 months and do a repeat echo and see if the size of the septum has gone down. If yes then it is nothing to worry and even if it stays same and has not increased even then it is safe and nothing to worry.
I hope this answers your questions.
Customer: replied 2 years ago.
Thanks.. U say it enlarges abnormally and irregularly , how can you tell it's not present in my case?
Expert:  Dr .Saeed ahmed replied 2 years ago.
If it is abnormally and irregularly enlarged the echocardiographer has to report it. This is a standard protocol to report septal hypertrophy and whether is it present all over or just in a small area.
I hope this answers your questions.
Customer: replied 2 years ago.
Ok well all the echocardiographer told me was that the septum is thicker than normal, she didn't go into too much detail with me.. The actual report will go to my cardiologist.. So I've not seen the report yet
Expert:  Dr .Saeed ahmed replied 2 years ago.
Ok, i hope the full report does not confuses with irregular septal hypertrophy report. Tell me full report by copy pasting the report on this page.
I hope chat was helpful.
Have a nice day.
Customer: replied 2 years ago.
Ok thanks
Expert:  Dr .Saeed ahmed replied 2 years ago.
You are welcome. Have a nice day.. I will wait for you to accept my offer for additional services.
Have a nice day.
Customer: replied 2 years ago.
Hi can you let me know when you are online please?
Expert:  Dr .Saeed ahmed replied 2 years ago.
I am online and will be here for next 5 hours.
Customer: replied 2 years ago.
Ok I'm going to open a new question
Expert:  Dr .Saeed ahmed replied 2 years ago.
If you open a new question any expert can answer unless it is an exclusive request.

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