What is an enlarged heart?
An enlarged heart (cardiomegaly) is an increase in the size of the heart. It is not strictly a disease, it is a sign that another health condition is affecting your heart. Some conditions – such as pregnancy – increase demand on the heart. Other conditions can thicken the heart wall muscle or stretch out the heart chambers (dilate) which makes the heart larger.
Types
The heart can enlarge in two ways:
- Dilatation: The heart walls become thin, stretch out (dilate) and weaken. This enlarges the heart. Dilated cardiomyopathy can lead to heart failure, where the heart loses its ability to pump properly.
- Hypertrophy: The heart walls thicken causing the heart to become less efficient. This can happen in athletes and pregnant women, whose hearts undergo a high workload for long periods of time. Left ventricular hypertrophy (LVH) is the thickening of the muscle of the left lower heart chamber (ventricle) – the main pumping chamber of the heart. It can be caused by high blood pressure or aortic stenosis.
Causes
The health conditions that can cause your heart to enlarge are:
- high blood pressure
- coronary artery disease
- heart valve disease
- cardiomyopathy
- heart attack
- pulmonary hypertension – high blood pressure in the arteries that carry blood from the heart to the lungs.
- infections of the heart
- HIV infection
- thyroid disorders
- kidney disease
- genetic or inherited conditions
- pregnancy (peripartum cardiomyopathy or PPCM)
Symptoms
People with cardiomegaly may not have any symptoms until their condition becomes more severe. The symptoms you may experience include:
- shortness of breath
- chest pain
- heart palpitations (rapid, fluttering, or pounding heartbeat)
- arrhythmia (irregular heartbeat)
- dizziness
- fainting
- rapid exhaustion with physical activity
- swelling
Diagnosis
Your doctor will diagnose cardiomegaly by doing a physical exam and assessing your:
- signs and symptoms
- medical history
- family history
- test results
Some of the tests used to diagnose an enlarged heart are:
- echocardiogram
- EKG / ECG (electrocardiogram)
- chest X-ray
- exercise stress test
- MRI (Magnetic resonance imaging)
- blood tests to check for thyroid disease, infectious causes.
Treatment
The treatment for cardiomegaly depends on the underlying medical condition that is causing the problem and how much your heart is enlarged. The goal of treatment is to control your symptoms and prevent further complications. Your treatment may include medications, surgery and lifestyle changes. You and your doctor will discuss the treatment options and decide what is best for you and your circumstances.
Medications
- diuretics
- ACE (angiotensin-converting enzyme) inhibitors
- beta-blockers
- antiarrhythmics
- other blood pressure medications
Surgery and other procedures
- heart valve surgery
- coronary artery bypass surgery
- heart transplant surgery
- implantable cardioverter defibrillator (ICD)
- left ventricular assist device – a mechanical pump for heart failure patients
Lifestyle
You can lower your risk of developing other heart diseases and stroke by knowing and controlling your blood pressure, diabetes and blood cholesterol. It’s also important to lead a healthy lifestyle.
- Be smoke-free.
- Be more active.
- Aim for a healthy weight.
- Eat a healthy balanced diet – there are some specific diets you can follow that have been proven to reduce the risk of heart disease.
- Drink less alcohol.
- Manage stress.
Talk to your doctor about the lifestyle changes that will benefit you the most.
