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Cardiomegaly, or an enlarged heart, is not a standalone disease but rather a sign of an underlying disorder. It is typically observed through imaging tests such as a chest X-ray, and further diagnostic tests are necessary to identify the specific disease causing the enlargement.
The enlargement of the heart often occurs when the heart becomes weakened, which can happen in cases of heart failure. As a result, the heart has to work harder to pump blood throughout the body.
There are various causes for an enlarged heart, including cardiac injuries or specific types of heart diseases. In certain situations, such as during pregnancy or short-term stress, the heart may temporarily enlarge. However, the enlargement can also become permanent depending on the underlying condition.
Treatment for an enlarged heart typically involves a combination of medication, medical procedures, or surgery, depending on the individual case. The specific approach will be determined by the underlying cause of the cardiomegaly and the overall health of the patient.
Symptoms
Some people may not have any symptoms or signs of cardiomegaly. Others may exhibit the following cardiomegaly symptoms:
- Shortness of breath upon awakening
- Breathlessness, especially when resting flat
- An abnormal heart rhythm (arrhythmia)
- Edema or swelling in the legs, feet or stomach
Early detection may make treating an enlarged heart easier. If you are worried about your heart, speak with your doctor.
If you experience any of the warning indicators of a probable heart attack, dial your local emergency number:
- Chest pain
- Pain in the back, neck, jaw, or stomach; one or both arms; or other parts of the upper body
- Severe difficulty of breathing
- Loss of consciousness
Causes
An enlarged heart, also known as cardiomegaly, can be associated with various conditions and factors. Some of the conditions commonly linked to an enlarged heart include:
- Injury caused by a heart attack. It may be more difficult for the heart to pump enough blood to the body as a result of scarring and other structural cardiac abnormalities. The stress may cause cardiac enlargement and ultimately heart failure.
- Congenital heart defect. The heart muscle can enlarge and weaken due to issues with the heart’s structure and function.
- Cardiomyopathy. The heart frequently becomes thick or hard as a result of cardiomyopathy (damage to the heart muscles). As a result, the heart may have a harder time pumping blood.
- Heart valve disease. The heart has four valves that ensure that blood is flowing properly. The heart chambers may enlarge due to blood flow obstruction brought on by disease or damage to any of the valves.
- High blood pressure. The heart may have to work harder to pump blood to the rest of the body if you have high blood pressure. The cardiac muscle may enlarge and weaken as a result of the tension.
- Pericardial effusion. On a chest X-ray, an enlarged heart can be observed due to a buildup of fluid in the sac that houses the heart.
- Pulmonary hypertension. In this condition, the lung’s arteries blood pressure is elevated. Moving blood between the lungs and the heart requires more effort from the heart. The right side of the heart may become thicker or enlarge as a result of the stress.
- Anemia. In anemia, there aren’t enough healthy red blood cells to deliver enough oxygen to the body’s tissues. In order to make up for the blood’s shortage of oxygen, the heart must pump more blood.
- Cardiac amyloidosis. Amyloid, a protein, builds up in the blood in this uncommon disease and sticks to human organs including the heart. An irreversible thickening of the heart wall results from amyloid protein deposition. To pump blood, the heart has to work harder.
- Aerobic exercise. In certain athletes, regular and sustained activity causes the heart to expand. Typically, this kind of enlarged heart is not regarded as a sickness and does not require medical attention.
- Fat around the heart. On a chest X-ray, some people’s extra body fat that surrounds the heart may be visible. No therapy is required unless there are related heart issues.
- Thyroid disorders. Heart issues, such as an enlarged heart, can result from both an underactive thyroid gland (hypothyroidism) and an overactive thyroid gland (hyperthyroidism).
- Hemochromatosis. Numerous organs, including the heart, can accumulate iron. The lower left heart chamber may enlarge as a result of this.
Risk factors
Numerous factors can impact the risk of developing an enlarged heart. These factors include:
- Heart diseases. Heart enlargement may be caused by any heart condition, including congenital heart abnormalities and heart valve disease. To control heart disease, it’s crucial to have a healthy lifestyle and get frequent checkups.
- A family history of cardiomyopathy. Cardiomyopathy, a disease of the heart’s muscles, can run in families in some cases. If a parent or sibling has a history of having a thick, stiff, or enlarged heart, let your healthcare practitioner know.
- High blood pressure. Having a blood pressure reading higher than 140/90 millimeters of mercury qualifies as this.
- Other factors. Some other risk factors that could encourage the development of cardiomegaly is smoking tobacco, alcohol consumption, substance abuse, and inactive lifestyle.
Diagnosis
To assess whether an individual has an enlarged heart (cardiomegaly), a doctor typically follows a diagnostic process that involves:
- Blood tests. Blood testing may be used to confirm or rule out medical problems that could result in enlarged hearts. Blood tests to assess the levels of chemicals in the blood caused by heart muscle injury may be performed if an enlarged heart coexists with chest pain or other indicators of a heart attack.
- Chest X-ray. An X-ray of the chest can help reveal the health of the heart and lungs. In most cases, additional testing are required to ascertain whether an X-ray-detected heart enlargement is true and to identify its etiology.
- Electrocardiogram (ECG or EKG). The electrical activity of the heart is measured by this rapid and painless examination. Electrodes are applied to the arms, legs, and chest in the form of sticky patches. The electrodes are connected by wires to a computer, which shows the test findings. If the heartbeat is excessively rapid or too slow, an electrocardiogram (ECG) can demonstrate this. Signal patterns can be examined by a medical professional for indications of hypertrophy, or thickening, of the heart muscle.
- Echocardiogram. The heart’s size, structure, and movement are visualized using sound waves in this noninvasive examination. The effectiveness of the heart’s function can be assessed by an echocardiography, which visualizes blood flow across the heart chambers.
- Exercise tests or stress tests. These tests often involve performing an exercise stress test using a treadmill or stationary cycle while monitoring the heart rate. Exercise testing helps evaluate how the heart responds to physical exertion. In cases where an individual is unable to exercise, the doctor may prescribe medications that simulate the effects of exercise on the heart. These medications aim to mimic the cardiovascular changes that would typically occur during exercise, providing valuable information about the heart’s function and response.
- Cardiac Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI). You typically lay on a table within a doughnut-shaped scanner for a heart CT scan. The machine’s internal X-ray tube spins around your body while taking pictures of your chest and heart. During a cardiac MRI, patients are positioned on a table that slides into a cylindrical machine resembling a tube. This advanced technology utilizes a combination of magnetic fields and radio waves to generate signals, which are then translated into detailed images of the heart.
- Cardiac catheterization. In order to inject dye into a cardiac artery, a doctor threads a thin tube (catheter) through a blood vessel in the arm or groin. As a result, the cardiac arteries are easier to see on an X-ray. The pressure inside the heart’s chambers can be evaluated during a cardiac catheterization to determine how vigorously blood is pumped through the organ. A tiny amount of cardiac tissue may occasionally be taken for a biopsy.
- Genetic examination. A test to determine if a hereditary condition is causing an individual’s enlarged heart.
Treatment
The appropriate treatment for an enlarged heart (cardiomegaly) depends on identifying and addressing the underlying cause of the heart issue. Once the specific cause has been determined, the treatment plan can be tailored accordingly.
Medications
The following medicines may be suggested by a doctor if cardiomyopathy or another form of cardiac problem is the reason for an enlarged heart:
- Diuretics. These medications assist lower blood pressure by lowering salt and water levels in the body.
- Other blood pressure drugs. To lower blood pressure and enhance heart function, physicians may prescribe beta blockers, Angiotensin-Converting Enzyme (ACE) inhibitors, or Angiotensin II Receptor Blockers (ARBs).
- Blood thinners. Anticoagulants, which thin the blood, may be administered to lower the risk of blood clots that could result in a heart attack or stroke.
- Heart rhythm drugs. These drugs, often known as anti-arrhythmics, aid in heartbeat regulation.
Surgery or other procedures
Medical devices and surgery can be required to treat an enlarged heart if drugs are ineffective.
Treatment for an enlarged heart may involve surgery or other techniques, such as:
- Pacemaker. A pacemaker is a little gadget that is often inserted close to the collarbone. The pacemaker is connected to the inner heart by one or more wires with electrode tips that travel through the blood vessels. The pacemaker emits electrical impulses that prompt the heart to beat steadily if the heart rate is too slow or stops.
- Implantable cardioverter-defibrillator (ICD). A surgeon may implant an implanted cardioverter-defibrillator (ICD) if your enlarged heart is causing major heart rhythm issues (arrhythmias) or if you are at danger of dying suddenly. Similar to a pacemaker, an ICD is a battery-operated device implanted under the skin close to the collarbone. The heart is reached by one or more electrode-tipped ICD wires that travel through veins. The heart rhythm is continuously monitored by the ICD. The heart rhythm is reset by low- or high-energy shocks when the ICD notices an irregular heartbeat.
- Heart valve surgery. Surgery may be required to replace or repair the afflicted valve if cardiac valve disease is the root cause of the enlarged heart.
- Coronary bypass surgery. This open-heart surgery may be performed to reroute blood flow around a blocked artery if an enlarged heart is caused by a blockage in the coronary arteries.
- Left Ventricular Assist Device (LVAD). Your doctor can suggest this implantable mechanical pump to help your heart pump if you have heart failure. While you are waiting for a heart transplant or, if you are not a candidate for a heart transplant, as a long-term treatment for heart failure, you may have a left ventricular assist device (LVAD) placed.
- Heart transplant. In cases where an enlarged heart is uncurable and other treatment options have been exhausted, a heart transplant may be considered as the final treatment option. However, the availability of donor hearts is limited, which can result in a significant waiting period, even for individuals who are critically ill and in need of a transplant.
