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A mildly dilated right atrium

It’s shallow, I know, but I always look forward to the yearly electrocardiogram (ECG). There’s always that moment when the nurse looks confused, pauses, and then asks if it’s normal for my resting heart rate (RHR) to be below 50BPM. FLEX! Everything was going to plan this year, except that for reasons that aren’t entirely clear, the ECG indicated left ventricular hypertrophy (LVH). My doctor was largely unconcerned, mentioning something about how that happens with thin people, but ordered an echocardiogram (Echo) just to be safe. Now, it is quite true that I have the upper body development of a thirteen year old boy perfect for cyclists. So while concerned, I was willing to roll with it while waiting for the Echo.

As you can probably guess from the title, I do not have LVH, but I do have “a mildly dilated right atrium”. Which freaked me out a bit (lot) even though my doctor said it was nothing to worry about. Some quick Googling was the opposite of calming, so I did what I do whenever I have a medical question, and my searchfu lets me down – asked the 182lb Pure Climber. Apparently the key word which made the difference between “panic” and “FLEX” was “athlete”, because what a world of difference in the results…

I’ve included some links below (first one is the easiest read), and there are more out there, most of which conclude that a dilated right (and left) atrium is a common artifact among endurance athletes, much like the abnormally low RHR. The heart adapts to training volume and intensity, and unlike RHR appears to be completely reversible. It’s particularly interesting how sparse the data around this is though, but as was pointed out by the 182lb Pure Climber, it’s quite likely that there are plenty of undiagnosed endurance athletes running around. After all, the only reason I found out was because a) I get an annual ECG (most don’t) and b) this falsely indicated LVH.

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