What is an enlarged heart (cardiomegaly)?
An enlarged heart (cardiomegaly) means that your heart is larger than normal. Your heart expands if the muscles work too hard or the chambers expand. An enlarged heart is not a disease. It is a symptom of a heart defect or condition that causes the heart to become harder, such as cardiomyopathy, heart valve problems, or high blood pressure.
An enlarged heart does not pump blood as efficiently as an enlarged heart. This can lead to problems like stroke and heart failure. Certain conditions can cause the heart muscle to thicken, leaving one of the heart’s chambers larger. Depending on the condition, the enlarged heart can be temporary or permanent. An enlarged heart can be treated by correcting the cause. Treatment for an enlarged heart may include medications, medical procedures, or surgery.
Types of an enlarged heart
The heart enlarges because of damage to the heart muscle. Up to a point, an enlarged heart can still pump blood normally. As the condition progresses, though, the heart’s pumping ability declines. Dilated cardiomyopathy is the main type of enlarged heart. The walls of both sides (also known as ventricles) become thin and stretched. This enlarges your heart.
In the other types, the muscular left ventricle becomes very thick. High blood pressure may cause your left ventricle to enlarge (a type known as hypertrophy). The thickening (which doctors call hypertrophic cardiomyopathy) can also be inherited. An enlarged heart keeps more of its pumping ability when it’s “thick” rather than “thin.”
What are the symptoms of an enlarged heart?
Sometimes an enlarged heart doesn’t cause any symptoms. When symptoms do occur, they include:
- Difficulty breathing
- Irregular heartbeat (arrhythmia)
- Swelling of the legs and ankles due to increased fluid (edema)
Symptoms that indicate a medical emergency:
- Chest pain
- Difficulty holding your breath
- Pain in the arms, back, neck, or jaw.
Causes of an enlarged heart
An enlarged heart is caused by conditions that cause your heart to pump harder than normal or damage your heart muscle. Sometimes the heart becomes enlarged and weak for unknown reasons. This is called idiopathic cardiomegaly. Damage from a congenital (congenital) heart condition, a heart attack, or an abnormal heartbeat (arrhythmia) can cause your heart to dilate. Other conditions associated with an enlarged heart include:
- Hypertension: Your heart needs to pump hard to supply blood to the rest of your body, to stretch and tighten your muscles.
- High blood pressure: Causes the left ventricle to dilate, eventually weakening the heart muscle. High blood pressure also expands the chambers above the heart.
- Heart valve disease: The four valves in your heart allow blood to flow in the right direction. If the valves are damaged due to conditions such as rheumatic fever, heart defects, infections (infective endocarditis), irregular heartbeats (atrial fibrillation), connective tissue disorders, certain medications, or radiation treatments for cancer, your heart may enlarge.
- Cardiomyopathy: This heart disease makes it difficult for your heart to pump blood throughout your body. As it develops, you can try to pump more blood into the vagina.
- High blood pressure in the artery connecting the heart and lungs (pulmonary hypertension). Your heart needs to be pumped hard to move blood between your lungs and your heart. As a result, it can expand to the right side of your heart.
- Fluid around your heart (pericardial effusion): Fluid buildup in the sac that contains your heart makes your heart appear enlarged on a chest X-ray.
- Blocked arteries in your heart (coronary artery disease): With this condition, fatty plaque in the coronary arteries blocks blood flow through the coronary arteries, leading to a heart attack. When a section of the heart muscle dies, your heart must pump hard to get enough blood to the rest of your body, causing it to expand.
- Low red blood cell count (anemia): Anemia is a condition in which there are not enough healthy red blood cells to carry enough oxygen to the tissues. Untreated chronic anemia can cause a fast or irregular heartbeat. Your heart needs to pump more blood so there is no oxygen in the blood.
- Thyroid disorders: Both a dysfunctional thyroid gland (hypothyroidism) and an overactive thyroid gland (hyperthyroidism) can lead to heart problems, including an enlarged heart.
- Excess iron in the body (hemochromatosis): Hemochromatosis is a disorder in which your body does not metabolize iron properly, which occurs in various organs, including the heart. It causes enlargement of the left ventricle due to the weakening of the heart muscle.
- Rare diseases that affect your heart, such as amyloidosis: Amyloidosis is an abnormal protein that circulates in the blood and can build up in the heart, disrupting the heart’s function and causing it to expand.
Diagnosis of an enlarged heart
An early diagnosis of an enlarged heart is very necessary to control or improve the condition. On a physical exam, the doctor may hear abnormal heart sounds or fluid in the lungs or swelling in the legs, ankles, or abdomen. Advanced tests to carefully diagnose, treat, and monitor the condition effectively include:
- Blood tests: Blood tests measure the levels of certain fats, cholesterol, sugar, and proteins in the blood, which indicate heart conditions.
- Cardiac catheterization: A long, thin flexible tube is inserted through a blood vessel in the arm or groin and into the heart. The contrast material is injected through a tube and a kind of X-ray video is taken to show how the heart is working and to see the heart block. A small piece of the heart tissue may be taken for laboratory analysis.
- Chest X-ray: A simple imaging test of the lungs, lungs, heart, and aorta.
- Computed tomography (CT) angiography: This non-invasive exam shows the arteries in the abdomen, pelvis, and legs. This test is especially useful in patients with pacemakers or stents.
- Echocardiogram: This ultrasound test uses sound waves to take moving images of the heart’s chambers and valves.
- Electrocardiogram (EKG): An EKG measures the electrical activity of the heart and can detect an enlarged heart and determine whether the heart is overactive or damaged. The electrical currents of the heart are detected by 12 to 15 electrodes through the adhesive tape on the arms, legs, and chest.
- Magnetic Resonance Imaging (MRI): A large magnet, radio waves, and a computer are used to create images of the heart and blood vessels.
- Stress test: This test is done while you exercise. If a person is unable to exercise, medications are given to increase the heart rate. In addition to the ECG, the test shows changes in blood pressure along with heart rate, rhythm, or electrical activity. Exercise-The heart works harder and beats faster when heart tests are done.
How enlarged heart is treated?
Your doctor will prescribe a treatment plan for the condition that is causing your heart. For example:
- Hypertension: ACE inhibitors, angiotensin receptor blockers (ARBs), and beta-blockers
- Irregular heart rhythm: Antiarrhythmic drugs, pacemakers, and implanted automatic defibrillator (ICD)
- Heart valve problems: Surgery to repair or replace a damaged valve
- Narrow coronary arteries: Percutaneous coronary intervention, coronary artery bypass graft (CABG), and nitrates
- Heart failure: Diuretics, beta-blockers, inotropes, and, in some minorities, the left ventricular assist device (LVAD)
- Other approaches can address congenital heart defects. If you try some treatments and they don’t work, you may need a heart transplant.
Changes in lifestyle
With lifestyle changes like these, you can maintain an enlarged heart:
- Exercise: Exercise most days of the week. Ask your doctor what types of exercises are safe for you.
- Give up smoking: Techniques like nicotine restoration products and treatment can help stop it.
- Lose weight: Weight loss will be followed by constant fatigue and tiredness.
- Limit certain foods: Limit salt, cholesterol, and saturated and trans fats in your diet.
- Avoid certain things: Drugs such as alcohol, caffeine, and cocaine should be avoided.
- Chill out: Follow relaxation techniques like meditation or yoga to reduce stress.
Enlarged heart complications
The risk of complications from an enlarged heart depends on the enlarged part of the heart and the cause.
Problems with an enlarged heart include:
- Heart failure: An enlarged left ventricle, one of the most serious types of enlarged heart, increases the risk of heart failure. In heart failure, the heart muscle weakens and the ventricles dilate (dissociate) until the heart can efficiently pump blood throughout the body.
- Blood clots: Having an enlarged heart is more likely to cause blood clots in the lining of the heart. If clots enter the bloodstream, they can block blood flow to vital organs and even cause a heart attack or stroke. A clot on the right side of your heart can travel to your lungs, a dangerous condition called a pulmonary embolism.
- Heart murmur: For people whose hearts are enlarged, two of the four heart valves, the mitral and tricuspid valves, do not close properly because they rupture, causing backflow of blood. This flow creates sounds called heart murmurs. Although it is not necessarily harmful, your doctor should monitor your heart murmurs.
- Cardiac arrest and sudden death: Sometimes an enlarged heart can lead to heart rhythm interruptions. Heart rhythms that allow the heart to beat too slow or too fast to move blood can lead to epilepsy or, in some cases, cardiac arrest or sudden death.
Prevention of enlarged heart
- Tell your doctor if you have a family history of conditions that can cause an enlarged heart, such as cardiomyopathy. If cardiomyopathy or other heart conditions are diagnosed early, treatments can prevent the disease from getting worse.
- Controlling risk factors for coronary artery disease (smoking, high blood pressure, high cholesterol, and diabetes) can help reduce the risk of heart enlargement and heart failure by reducing the risk of a heart attack.
- Eating a healthy diet and avoiding alcohol abuse or illicit drug use can help lower your chances of heart failure. Controlling high blood pressure with diet, exercise, and possibly medication can prevent many people with an enlarged heart from stopping.
Recovery after dilated heart surgery
The length of your hospital stay depends on the process.
- After a coronary artery bypass graft, you spend a day or two in the intensive care unit and another three to five days in another unit before returning home. Full recovery can take 6 to 12 weeks. Your doctor will tell you when you are physically active again, return to work, or resume sexual activity.
- Recovery after ventricular assist device surgery depends on your condition before surgery. You spend a day or two in the intensive care unit and another three to five days in another unit before going home. You make a slow transition from the hospital to the home, which may be the first day you are home, but you return to the hospital that night. Your doctor will advise you on activities you can participate in until you fully recover.
- After heart valve surgery, you will spend one to two days in the intensive care unit and three to five days in another unit before going home. Full recovery can take 6 to 12 weeks. Your doctor will tell you when to be active again.
- After heart transplant surgery, you spend several days in the intensive care unit before going home and several weeks in another unit. After discharge, you must be very close to the hospital for the first six weeks for frequent subsequent visits and lab tests. Your doctor will advise you on activities you can participate in until you fully recover.