Weightlifting with possible DCM

pastorpaul1984

Hi everyone

There is an outside chance that I have familial dilated cardiomyopathy (seeing cardiologist in January). My doctor told me I could workout as normal but to stop if I felt dizzy. But DCM can hit suddenly.

Does anyone here have experience with DCM and if so, how has it effected your exercise habits?

Azdak

Have you been having symptoms or a diagnostic test or is this just something you want to explore because of family history?

Without clinical data, it’s hard to be specific. The biggest immediate risk with cardiomyopathy is a sudden arrhythmia (hence the concern re dizziness). The effects of the actual deterioration of heart function are more gradual.

Longer term, the effects are going to come from side effects of any medical treatment or increased fatigue/decreased endurance from the reduced heart function.

To be honest, by the time someone with heart failure came to me, they were usually at a more advanced stage and we were just trying to marginally increase their functional capacity. A younger, more fit person would probably be able to do quite a bit. There was a study about 10 years ago where they actually did some high-intensity cardio training with people who had heart failure with no adverse incidents. (Although I have to admit, just reading the study protocol scared me a little ;-)

There may be some recommendations to avoid breath holding with heavy lifting but even with a diagnosis, I suspect you will not have that many restrictions.

pastorpaul1984

Thanks for the reply Azdak

I haven’t had any symptoms, or an echo (yet) and my bp when I took it today was 115/75, and so I’m apparently in good health.

My brother does have it, and my mother has arrhythmia and may also have cardiomyopathy, which is why I'm seeing a cardiologist in January. Sometimes sudden death is the first symptom of DCM.

I guess that was one of my concerns: would weight lifting put to great a strain on a heart, leading to sudden death? Especially given the explosive movements involved, could that put too great a strain on a heart?

Azdak

The physiological load on the heart during weight lifting is different than the load imposed during aerobic exercise, even when heart rate responses are similar.

Lifting weights increases the pressure load on the heart—meaning the heart has to pump more forcefully to push the blood through higher resistance (as opposed to aerobic exercise where the heart has to pump a higher volume of blood through relatively low resistance). This load becomes more acute with heavier weights, changes in body position, and overhead lifts. So lifting would be a concern, but only if there was clinical evidence of impaired left ventricular function and evidence of an increased predisposition to cardiac arrhythmia.

From what I could tell doing some additional reading, familial DCM has not been studied as extensively has hypertrophic cardio myopathy, so the risk of adverse effects during exercise is not well defined in the literature.

There are guidelines for risk stratification based on the overall diagnostic picture—which includes family history—with specific restrictions for each level.

I don’t think a family history of DCM alone would be enough to restrict weightlifting activity—there would have to be clear evidence of enlargement, reduced ejection fraction, etc—in addition.

Good luck.