Im a 35 year old guy whos always been very fit and don't smoke.

I must admit though i do drink very heavily on occations , (binge drink episodes)

I have recently been for an annual check up and everything was fine except for i had a heart murmur.

On further checks it was discovered that i had a mild leak in my mitral valve, my LA and LV chambers were slightly enlarged and the heart wall was slightly thickened.

After stress test etc, the advise of the doctor was not to worry, and carry on the way i was.

Since then however, i have been worried sick and researching the internet to find out more information.

I have cut down drinking, but i still train hard in the gym, sometimes i feel a bit light headed.
any advise as to what progress may be made, still train hard? drink? etc.... is damage that has already been done reversible???

Hi Wildpikey,

An enlarged heart and wall thickness indicates (usually) the heart is compensating and overworked due to a cardiovascular problem. Unless the size is NORMAL for you, it is generally not normal and should be treated. My heart size returned to normal after taking medication to dilate vessels (reduce hypertension and heart rate) and as the workload for the heart was reduced so was size.

Many people who drink alcohol excessively have an abnomally enlarged heart! I'm not sure of the physiopathology but it may be due to damage artery walls causing the heart to work harder or it may place a higher need for more oxygen for a period of time and the heart does not return to normal between episodes of drinking. Also, if in a smoking environment, there can be damage to artery walls and then heart problems. Whether or not your heart size can be reduced depends on the underlying reason...a large person and/or athlete may have an enlarged heart with strong contractions that is more than adequate to meet the body's need for oxygen rich blood.

For some perspective, the reason for an abnormally large heart size and wall thickness is an attempt to meet oxygen demand by increasing capacity and elasticity (contractions) are stronger. But as it continues to enlarge there is point when elasticity decreases ( i.e. same as stretch a hand spring and it snaps back, but to over stretch it becomes inflexible) and cardiac output decreases causing heart failure.

A minor leak of the MV may be insignificant, but should be monitored.

Ken, I too have wondered about the enlarged heart problem.
I've not seen any reference to alcohol causing this problem directly, but would be interested to read about it.
More generally, I think there must be something else to the story because otherwise athletes would have problems too, caused by the increased demand by their bodies for oxygen. Guessing - it might be that, in a diseased body, the increased oxygen demand causes the heart to enlarge but the vascular system is relatively fixed - specifically the walls of arteries around the heart. The result then would be an even greater imbalance between the size of the heart and the capacity of the arteries supplying the necessary blood.
Only last night I glanced at the back of my hands and was amazed how pronounced the arteries and veins were, and how they had responded so quickly. These have developed since I started my stronger exercise routines just a few months ago. If I achieved anything like that in the arteries around my heart I would be in great shape. So, based on this thin logic, it's the inflexibilty of the cardiovascular arteries and their lack of any capacity to grow and meet the demands of the new heart, that causes the problem. Unfortunately the plague does not deposit evenly in the arteries but centres on the cardiovascular system - why this is I do not know.

It's interesting that some recent research in Australia has shown that plaque can be detected on the arteries of children as young as 6, and the plaque can be gradually removed by a steady exercise routine (the plaque was found in those that did not exercise). At this age the arteries are of course growing and very flexible. Keeping them flexible prevents the plaque buildup.

Wildpikey, Unfortunately you cannot compensate for the binge drinking by working out more in the gym. You must break the pattern and the first step you have made, which is to recognise there is a problem, is quite positive.
I am much older than you but I had a choice of gradual destruction through alcohol or trying at least to achieve something better in my life. The statistic that got me was that 30% of men over 60 that enter hospital do so because of alcohol-related diseases. I could see where I was headed - I chose not to go down that path. I got up to the point of deciding to attend an AA meeting
when I gave up.
Hypnosis is a powerful technique that can help you in that - don't be afraid to use it.
Beefy :wave:

my LA and LV chambers were slightly enlarged and the heart wall was slightly thickened.

After stress test etc, the advise of the doctor was not to worry, and carry on the way i was.



pikey,

Call your doctor and get the meaning of his use of the term "slightly"...ask him frankly if he would judge that you are suffereing cardiomyopathy.
If he says NO, then forget all about it. If he says YES then tell him you want your ejection fraction measured.

It's likely there's no reason to worry because normal heart size follows a bell curve distribution and very few people are smack dab in the middle. Even bigger people tend to have bigger hearts and exercise can thicken a heart wall.

I think the cardiomyopathy from drinking is overamplified a bit, especially in countries with Victorian attitudes. It occurs, but it's not rampant. Far more dangerous is the effect of long term alcohol abuse on the LIVER...and alcoholic dementia isn't pretty.
If anything, the evidence might point to the cardioprotective aspects of drinking, even very heavy drinking...though nobody wants to go out on a limb with this theory.

Alas, until somebody can remove the calories from alcohol, I must remain almost a teetotaller myself.;)

Beefy,

You have an interesting theory.

My take on the matter is that an athlete's heart has muscular and better contractility of the heart's wall, and as a consequence has superior ability to meet the demand for oxygen with less effort when needed and at rest fewer heart beats to meet demand.

There may be a connection between alcohol and muscle tone and muscle tissue fibers. Rather than an artery problem it may be the athlete's heart has strong, connecting tissue fibers from exercising (the same with skeletal muscles), and excessive drinking may deteriorate heart muscle tissue causing the heart to enlarge to compensate for less contractility to pump blood with each heart beat. Maybe a fat heart!:D

Thanks for the replys. Glad to see anything here at all.. first time ive tried doing this sort of thing , its because i really was getting no results fomr the WWW and the doctors ive seen are just, well, clueless!!!.....

Mention the word alcohol to any doctor and they **** them selves, become all smug and say, well give up then. (cover the arse routine)

same as mention that you may be worried about the heart at 35 and they smirk like your some sort of ediot... (it could never happen type of thing)

I had a associate who died of a heart attack recently, and he was a very fit guy and only just over 40.

well giving up, if i have to is not a problem,. but i certainly aint gonna give up because a doctor doesnt really know what to say to me. As i do enjoy drinking, im afraid to say its part of my social life...(but i must admit i get carried away sometimes)

I'm still doing a full on physical routine and i can easily run 6 miles in an hour no problems, and carry on to do weights etc afterwards.

anyway. not sure what im getting at exactly, just waffleing on trying to get someone to tell me that "there is no problem" etc. LoL...

any more advise well appreciated.... hope to read more...

Alchohol can play a major role in onset of dilated cardiomyopathy along with drug abuse (cocaine). I was recently diagnosed with dilated non-ischemic cardiomyopathy,which is non disease related. I myself was a very fit person and a binge drinker and all of the sudden lost my stamina. I ended up in the ER with shortness of breatheand chest pressure. I had an ekg done and it turned up abnormal. I was admitted and given stress test,echo,and cardio cath. They told me I had dilated cardioomyopathy with an EF of 20%,I was shocked! I have since changed my diet,following meds,low impact exercise,no drinking,and stopped smoking. I just had a new stress test and echo done and my Ef has jumped up to 35%! I just turned 36 and can understand your anxeity over the situation. The most important thing to do is talk to your doc if you are not satisfied with what he says,get a 2nd opinion. I would chill on how hard you push yourself working out until you get some answers or tests.

It is true the type of heart muscle disease produced by alcohol is known as dilated cardiomyopathy with one or both left chambers dilated. It is pathologically indistinquishable from other dilated cardiomyopathy conditions. Dx depends on history of excessive alcohol consumption and the absence of any other known cause of the condition.

"There are three stages of alcoholic cardiomyopathy: p r e c l i n i c a l (asymptomatic), acute, and chronic. The p r e c l i n i c a l and acute stages are usually reversible when alcohol abuse is discontinued, except in cases of sudden congestive heart failure (see next section) or acute heart muscle degeneration. Chronic alcoholic heart muscle disease often can be arrested or improved with abstinence (Rubin 1979)".


The pathology is heart muscle degeneration with a loss of contractile function as the cells of the myocardium in the left ventricle (primary target). The loss of contractile efficiency of the heart's output leads to decreased stroke volume. There is a backup of returning blood to the LV and it begins to dilate. Blood pressure decreases as a result of decreasing output. The drop in BP serves for a series of compensatory mechanisms, regulated in part by the nervous system.

The most striking comp is the retention of fluids and that increases volume of blood causing the LV to stretch even further before contraction. The distention tends to restore stroke volume to normal, partly because stretching a suscle stimulates it to contract more forcefully.

Benefits are short as excessive stretching evenually decreases contractile strength and the heart reacts by increasing bulk*** (reference beefy's theory)*** that also becomes a liability as the distribution of blood vessels within the cardium is insufficient to oxygenate the oversize muscle cells. Abnormalities of metobolic function and protein synthesis within muscle cells also contribute to impaired contractility of the hypertrophed muscle. (Also arteries may be unobstructed but can be constricted to some extent by scar tissue surrounding the artery walls.) Scarring of the inner layer of the heart wall and also the heart itself is common!?