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Dr. K.
Dr. K., Board Certified MD
Category: Medical
Satisfied Customers: 3995
Experience:  Board certified with experience in primary care.
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Hi a quick question about an echocardiogram I had today, I

Resolved 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?
sorry for repeating this question.. The other Dr has not got back to me with a reply
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. K. replied 2 years ago.
Dr. K. :

Hello, this is Dr K.. Answers are not medical advice and do not constitute a doctor/patient relationship. I look forward to helping you today.

Dr. K. :

You should of course wait for your cardiologist to get back to you because the results of the echo are not based on a single measurement

Dr. K. :

That said, the septum measurement you provided is thickened.

Dr. K. :

I am wondering why the echo was ordered. Are they following you for hypertrophic cardiomyopathy?

Dr. K. :

It is not the exercise and working out that is causing the changes.

Customer: Hi, the rest of the measurements were normal
Dr. K. :

Thats a good sign. But that measurement is off and can be an early sign of septal hypertrophy.

Dr. K. :

Try to discuss it with your cardiologist as soon as possible

Customer: Thanks I have spoken to a cardiovist on here and he said the following
Customer: Dr .Saeed ahmed :Hello, Thank you for your question. I will try my best to help you with your questions. Dr .Saeed ahmed :High blood pressure and high endurance exercises are main cause of septal hypertrophy.Dr .Saeed ahmed :If you were doing body building or high endurance exercises then it is a normal response that heart muscles including the septum will thicken.Dr .Saeed ahmed :This is very normal.Dr .Saeed ahmed :Let me know if you have questions Customer: 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 itDr .Saeed ahmed :noDr .Saeed ahmed :sudden death is a risk which increases when your septum approaches around 30mmDr .Saeed ahmed :1.5 is a borderline thicknessDr .Saeed ahmed :and does not increase the chance of sudden deathCustomer: 2 mins.. Someone is. At the doorCustomer: 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?Dr .Saeed ahmed :It is totally incorrect... Septum is the first part that thickens in case of high endurance exercise.Customer: :-)Dr .Saeed ahmed :It is only because of this reason we use septum as a land mark for testing HCM or hypertrophic cardiomyopathyDr .Saeed ahmed :against athletes heart.Customer: 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?Dr .Saeed ahmed :Yes it is reversible.Customer: Is it reversible if I stop training? Or should I continue trainjng?Dr .Saeed ahmed :reversible if you stop training for 6 months and then go for echo again Dr .Saeed ahmed :it will show less thicknessDr .Saeed ahmed :and then you can continue with your exercise because this will be a proof that it is athletes heart.Customer: Ok but if I continue training then am I at risk ?Dr .Saeed ahmed :1.5cm thickness is not a risk, you are at low risk of sudden death. Dr .Saeed ahmed :risk arises when your thickness is around 30mm or 3 cmDr .Saeed ahmed :you can continue exercise as you are not at riskCustomer: Should I carry on as normal? Go back to work?Dr .Saeed ahmed :i just mentioned the protocol for stopping exercise and getting echo to help you understand how we differentiate HCM and athletes heart Dr .Saeed ahmed :you can continue as normalDr .Saeed ahmed :there is no risk at all.Customer: Will my cardiologist agree with everything u have told me?Dr .Saeed ahmed :yes, because i am a cardiologist and this is a world over protocol that we do everywhere in such cases.Dr .Saeed ahmed :I hope this answers your questions,Customer: 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 gymCustomer: What times do u be online if I need to come back to u?Customer: Meant to say average guyDr .Saeed ahmed :It is trueDr .Saeed ahmed :athletes heart is a heart of high endurance exercising person.Dr .Saeed ahmed :In your case it is just 1.5cm which is not thick at all as compared to HCM or athletes heartDr .Saeed ahmed :So no risk in your caseCustomer: So me going and doing weights 3 times a week is classed as high endurance?Dr .Saeed ahmed :Yes it is Customer: In the UK they say 1.2cm is the normal limitDr .Saeed ahmed :I have to pick my kids from school see you after few hours.Dr .Saeed ahmed :Yes it is same all over 1.2-.1.3 cmsDr .Saeed ahmed :bye for now will see your reply after picking up kids from school.Customer: Ok thanks for the adviceDr .Saeed ahmed :you are welcome.Dr .Saeed ahmed :Do rate my answer to credit the reply. Have a nice day.Dr .Saeed ahmed :You can always come back in our cardiology section and ask questionsCustomer: Ok .. Are u UK based?Dr .Saeed ahmed :or ask by direct request for S.A.AlamDr .Saeed ahmed :I have degrees from UK.. but not basically from UKCustomer: I was just thinking of the time difference.. When are u best to get hold of?Dr .Saeed ahmed :What is time at your place ?Dr .Saeed ahmed :Is it 10:10 am at your place or time zone ?Customer: It's 10:10amDr .Saeed ahmed :From your time zone it would say best time to find me is from 3:00 pm to*****.Saeed ahmed :It do come online before that like 10 am in your time zoneDr .Saeed ahmed :but just to check mail Customer: 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?Dr .Saeed ahmed :1... It is correct.Dr .Saeed ahmed :2... It is correctDr .Saeed ahmed :3... It is correct.Customer: Lol okDr .Saeed ahmed :I hope this answers your questions.Dr .Saeed ahmed :Do rate my answer if no further questions at this time. Have a nice day.
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
Dr. K., Board Certified MD
Category: Medical
Satisfied Customers: 3995
Experience: Board certified with experience in primary care.
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