Heart & Cardiology/PVCs and IRBBB


Dr. Richardson

Hi, I am a 5'11 165 lb 27 yr old white male. Very active all my life and have never had any health issues. I eat extremely healthy and currently train Jiu Jitsu five times a week (very cardio intense). Moderate alcohol and caffeine consumption. No meds just supplements which are whey protein, creatine, fish oil (3g a day), Vit D (2,000 IU) and Magnesium (300 mg). I had a check up the other day and my doc said she heard a heart murmur. I told her I was unaware of this but could feel a bigger heart beat every 4-5 beats. Especially when hungover and stressed I could feel this more often, figured it was just a stress issue. Had an ECG and it came back with IRBBB with occasional PVCs. Was sent to cardio to get Echo and heart is physically normal/healthy but they did notice the IRBBB and PVCs. Doc was saying she thinks it could be Athletes heart and maybe should tone down my training. This had me very nervous and scared that I wasn't ok and that I would have to limit myself physically from here on out. Researched and saw that a lot of elite level athletes and triathletes have these same issues. Came back next day to give blood and urine to see if liver, kidneys, thyroid, and electrolytes were good and all came back normal. They want me to wear a holter next week just to see how many PVCs im having but their instinct is that Im going to be good.

So my question is if my heart is physically healthy (cardiologist mentioned heart looked really good) will these PVCs turn into health issues down the road? Will they effect my training? Should I tone back training?  

Also is it common to have both PVCs and IRBBB? Will they go away at some point in my life? Any precautions I should take like limit alcohol and caffeine?

I could barely sleep this week just thinking about all this. Doc says not to worry but I guess im not convinced. I know thats a lot of questions but Im worried. Any thought?

Thank you for your time Dr. Richardson, your expertise and opinions help greatly.


Hello Phillip,

A murmur is unimportant, forgettable in someone with a normal echo.

PVC's are harmless with a normal echo.   Premature beats are normal heart activity, easy to understand as normal from knowledge of the heart's electrical system and occurring in about half of us.  They don't mean you have heart disease or will in the future develop heart disease or any cardiac catastrophe.

Incomplete RBBB is also harmless, won't ever cause any trouble.

Please write back if this note doesn’t answer all your questions.

David Richardson

Heart & Cardiology

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David Richardson


Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.


Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Circulation, American Heart Journal, Hypertension.

M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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