Enlarged Heart: Symptoms, Causes and Treatments

Get the facts on the causes, risk factors, and symptoms of an enlarged heart (cardiomegaly). Learn how this condition is diagnosed and the current medications, procedures, and tests that are used to treat the underlying conditions that cause an enlarged heart.

An enlarged heart, or cardiomegaly, is the term used to describe a heart that has a thickened wall or dilated chambers. Having a heart that is enlarged is not a disease but a symptom of an underlying medical condition. When there is an increase workload on the heart due to disease, viruses, inflammation, or high blood pressure the heart must work harder to maintain normal function, which can result in an enlarged heart.

Enlarged Heart Symptoms

An enlarged heart can result from either a pathological or physiological condition. A physiological condition occurs when athletes or pregnant women have an enlarged heart without symptoms of heart disease/failure. While an enlarged heart caused by the inability of the heart to pump the volume of oxygenated blood to the body is the result of a pathological condition.

An enlarged heart tends to affect the heart ventricles, or the lower chambers of the heart. However, if the condition goes untreated, the upper chambers of the heart may also enlarge. The symptoms of an enlarged heart are observed when the heart can no longer pump the amount of the blood the body needs to function adequately. Here are some of the signs and symptoms of an enlarged heart:

  • Swollen legs
  • Increased abdominal girth
  • Thyroid problems
  • Weight gain
  • Edema
  • Shortness of breath
  • Abnormal heart rhythms
  • Palpitations
  • Cough
  • Chest Pain

Risk Factors for an Enlarged Heart

There are several factors that put an individual at greater risk for developing an enlarged heart. Here are some of the risk factors:

  • Family history of cardiomyopathy
  • Valvular heart disease
  • Coronary artery disease
  • High blood pressure
  • Congenital heart disease
  • Obesity
  • History of a heart attack
  • Cardiac ischemia

Causes of an Enlarged Heart

An enlarged heart can result from a variety of different causes. Hypertension (high blood pressure) and coronary artery disease are the most common underlying problems that result in heart enlargement. Over time, high blood pressure causes the heart to work harder to deliver oxygenated blood to the body, which leads to a thickened heart muscle. Coronary artery disease, on the other hand, creates fatty blockages in the blood supply to the heart that result in narrow heart vessels. The heart has to work harder to pump blood through these narrow heart vessels, which causes the heart muscles to over-stretch.

Besides, other conditions may also lead to an enlarged heart. These conditions include:

  • Genetic hypertrophic cardiomyopathy
  • A viral infection of the heart
  • A diseased heart valve
  • Pregnancy
  • HIV infection
  • Cocaine or alcohol abuse
  • Kidney disease controlled by dialysis
  • Various genetic conditions

Diagnosis and Tests of an Enlarged Heart

  • The diagnosis of cardiomegaly is determined by the patient's medical history and the results of several tests including an echocardiogram (ultrasound of the heart). The patient's medical history is often the first clue that the patient may have an underlying condition that could result in an enlarged heart. After a patient reports symptoms of an enlarged heart, additional tests/procedures are needed to determine the extent of heart enlargement.
  • An echocardiogram is the preferred diagnostic test to determine the extent of cardiomegaly because it gives a precise measurement of the heart's size and pumping ability.
  • Other tests including a chest x-ray, electrocardiogram, stress test, blood tests, cardiac computerized tomography (CT scan), magnetic resonance imagining (MRI), and cardiac catheterization are additional tests that can help the physician determine the extent of cardiac enlargement.

Treatments for an Enlarged Heart

Treatment for an enlarged heart depends on the underlying medical condition contributing to heart enlargement. A two-prong approach, centering on medical treatments and home remedies is the most effectively way to treat patients with an enlarged heart.

Medical Treatments for an Enlarged Heart

Medications

  • Diuretics to reduce the amount of sodium and excess water circulating around the heart.
  • Blood pressure lowering drugs.
  • Digoxin to help improve the pumping action of the heart.
  • Anticoagulants to decrease the chance of blood clot formation.

Medical procedures

  • Inserting a pacemaker to help regulate the contractions between the right and left ventricle.
  • Heart valve surgery to replace a leaky or defective heart valve.
  • Left ventricular assist device (LVAD) to help strengthen a weakened heart.
  • Coronary artery bypass surgery to remove diseased vessels.
  • Heart transplant surgery is the last resort when all other therapy options are not controlling the symptoms.

Home Remedies for an Enlarged Heart

  • Addressing the underlying medical condition, such as being overweight or obese.
  • Daily exercise to help improve the pumping action of the heart and remove excess body weight.
  • Eating a healthy diet low in saturated fats.
  • Maintaining regular contact with supervising physician to make sure the treatment plan is working effectively.

When to See the Doctor

If you are having any of the symptoms of heart disease mentioned above or have a strong history of heart disease in your family, you should schedule an appointment with your family physician. Early identification and treatment of heart disease is an important factor in effectively managing the disease.


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