Enlargement of the right ventricle

Hey Gang, looking for some “non-medical advice” after searching the forum.

Had a couple arrhythmias on the trainer earlier this year for the first time. No dizziness or tingling. My doc at the time (an avid runner) was not concerned. It hasn’t happened again since. I went to a new doc recently and they sent me in to see the cardiologist who had me do an electrocardiograph and surprise, surprise my right ventricle is enlarged. The cardiologist acknowledged they see this in athletes but wants to rule out other cause like a shunt. Makes sense, I’ll take all the tests. Inevitably family immediately plays the “too much exercise!” card :scream:

Who has navigated these conversations with family and doctors that aren’t focused on athletes? I’m 40, no history of health issues, been training “low volume” for about 6 years. My limited understanding is that the heart is a muscle and adapts like other muscles (thanks TR pod). What is less clear to me is how to distinguish an adaptation from a condition, described in this “googles something once” link…

Assessment of the athlete with palpitations, ventricular ectopics, or non-sustained ventricular arrhythmias can be very challenging. In general, ventricular arrhythmias in the absence of structural heart disease are not associated with an adverse prognosis. However, the exclusion of structural heart disease in athletes can be more difficult, especially in endurance athletes in whom pronounced remodelling is common. In athletes in whom cardiac imaging raises suspicion of cardiac pathology, a more comprehensive evaluation is necessary.

On one hand I feel like I am asking “why are my muscles getting bigger after lifting all these weights?!” on the other hand I’m trying not to circle the drain of hypochondria and some kind of family ban on VO2 intervals! :joy:


I had a scare a couple years ago when a scan for something else showed I had a mildly dilated aorta. First doctor told me to stop training and think of my kids (I don’t have kids) so I found a cardiologist who specializes in athletes. We discussed my risk tolerance and the current state of science since there are very few studies on endurance athletes that have been at it for decades. Anyways we’ve monitored it with tests every 9mo to make sure nothing is changing and it’s been perfectly stable.

My suggestions coming from my experience would be to work with your doctor. Discuss your risk tolerance with them and your family, and come up with a plan. The best weapon against family members screaming “Those hard efforts will make your heart rate go up and give you a heart attack!!!” Is to say you’ve discussed it with your doctor and the benefit of me exercising like this outweighs anything negative I’m doing to my body.

Hopefully you’re able to keep doing what you love while staying relatively safe.

I would politely ignore your family ,and put them at ease by assuring them you are seeing a specialist.
What is a “shunt” ? Not heard of this.
My husband was an elite level masters runner (o/60) and had a few episodes of arrhythmia.
After doing some tests , including wearing a monitor device for 24 hours, it was discovered he was experiencing some arrythmias he was not aware of, so not just while training at above threshold.
He was given Beta blockers, and advised to limit his training to under threshold HR.
He didn’t like the Beta blockers ,so stopped taking those. But he also didn’t want more episodes of arrhythmia, so decided to give up training and racing.
I think he got bad advice, and I asked if he would consider seeing a speciaist who had experience with athletes. He chose not to, and was quite happy to give up his racing carreer.
My advice ,for what it’s worth, is to continue to pursue , and seek the right treatment for you. Seeing as you are young ,and hopefully have a long and enjoyable athletic career ahead! Keep us posted how it goes. I know 4 or 5 people who race in my age category who have arrhythmias.

I had a heart attack at some point in my life. Don’t know when. Then I had an episode where I fainted. This led to an hospital admission, cardiac cath and a cardiac mri. I also have an enlarged right ventricle and some other changes found in athletes. I did also have some common arrhythmia but not life threatening. Because of the fainting spell and nothing Unusual on the cardiac cath, I was started on a monitor that I wore for two weeks. Nothing found with this test. So, I had a monitor placed under my skin and it sends data to the doctors office. This requires three years of monitoring in case I have another fainting spell. After 2 and a half years nothing has happened. I continue to ride and train. I do take more easy days for recovery. Overall, athletes have less risk of dying then people who are sedentary. So, I would go through all of the tests to see if there are any serious problems and stop hard training temporarily until you know more about your condition.