Cardiologist Warns Heavy Exercise Does Not Excuse a Thickened Heart Muscle

The Risks of a Thickened Heart

A thickened heart muscle is never normal, even for people who work out hard on a regular basis. Cardiologist Dr Dmitry Yaranov recently shared on Instagram that heavy exercise can sometimes lead to a dangerous condition known as hypertrophic cardiomyopathy, or HCM, rather than just harmless athletic changes. HCM is a heart muscle disease that can block blood flow, cause dangerous heart rhythms, and lead to symptoms like chest pain, shortness of breath, and fainting. The condition is diagnosed when the heart muscle measures 15 millimetres or more without another clear cause such as uncontrolled high blood pressure or a valve problem. Dr Yaranov also noted that some patients experience no symptoms at all, making an abnormal heart rhythm the biggest fear.

Family Risk and Treatment Options

Because HCM often runs in families, an abnormal echocardiogram detecting the disease serves as a red flag for the entire family. When a specific genetic variant is found, parents, siblings, and children should be tested, though a negative genetic test does not entirely rule out the condition. Doctors diagnose HCM by reviewing patterns of thickening, family history, genetics, cardiac scans, symptoms, and rhythm monitoring. While most people with HCM can live full lives, everyone needs an individualised rhythm risk assessment. Defibrillators are reserved for high-risk patients to protect against dangerous rhythms rather than to treat the thick muscle itself. Traditional medications slow the heart rate or reduce contraction force, while surgeries or alcohol septal ablation help with persistent blockages. Additionally, cardiac myosin inhibitors directly reduce excessive heart contraction, with evidence showing they may help patients even without obstruction.

Context

Hypertrophic cardiomyopathy is a genetic heart muscle disorder that can affect individuals regardless of their fitness levels. While regular physical activity is generally beneficial for cardiovascular health, underlying conditions like HCM require specialized medical evaluation and management rather than assuming heart changes are merely the result of exercise.