An enlarged heart (cardiomegaly) is not an illness in and of itself, but rather a symptom of another problem.
A "cardiomegaly" is an enlarged heart that can be observed on any imaging examination, including a chest X-ray. Other tests are subsequently required to determine the cause of the enlarged heart.
An enlarged heart can be caused by cardiac injury or some forms of heart disease. Short-term stress on the body, such as pregnancy, can cause the heart to grow in size. An enlarged heart might be temporary or permanent, depending on the situation.
Medication, medical treatments, or surgery may be used to treat an enlarged heart.
WHAT ARE THE SYMPTOMS OF AN ENLARGED HEART?
An enlarged heart (cardiomegaly) generates no symptoms in some persons. Others may exhibit the following signs and symptoms of cardiomegaly:
- Shortness of breath, particularly while resting down
- Short of breath when you wake up
- Heart rhythm irregularity (arrhythmia)
- Swelling (edema) in the abdomen or legs
WHAT ARE THE CAUSES OF AN ENLARGED HEART?
An enlarged heart (cardiomegaly) can be caused by heart muscle disease or any condition that causes the heart to work harder than usual, including pregnancy. For unexplained reasons, the heart can grow in size and become feeble. Idiopathic cardiomyopathy is the medical term for this ailment.
Conditions linked with an enlarged heart include:
- Heart disease apparent at birth (congenital heart defect): Problems in the structure and function of the heart can cause the heart muscle to become bigger and weaker.
- Heart attack damage: Scarring and other structural cardiac problems might impair the heart's ability to pump adequate blood to the body. The strain can cause cardiac enlargement and, ultimately, heart failure.
- Heart muscle diseases (cardiomyopathy): Cardiomyopathy frequently causes the heart to become stiff or thick. It can make the heart work harder to pump blood.
- Heart valve disease: Four heart valves keep blood flowing in the appropriate way. Damage or disease to any of the valves can disrupt blood flow and cause the heart chambers to expand.
- High blood pressure (hypertension): High blood pressure causes the heart to work harder to carry blood to the rest of the body. The tension might cause the heart muscle to enlarge and weaken.
- High blood pressure in the arteries of the lungs (pulmonary hypertension): To transfer blood between the lungs and the heart, the heart must work harder. The tension may cause the right side of the heart to thicken or expand.
- Fluid accumulation in the sac surrounding the heart (pericardial effusion): A buildup of fluid in the sac that houses the heart can result in cardiac enlargement, which can be detected on a chest X-ray.
- Low red blood cell count (anemia): Anemia is characterized by a deficiency of healthy red blood cells that transport enough quantities of oxygen to the body's tissues. To compensate for the shortage of oxygen in the blood, the heart must pump more blood.
- Thyroid problems: Heart issues, including an enlarged heart, can result from both an underactive thyroid gland (hypothyroidism) and an overactive thyroid gland (hyperthyroidism).
- Abnormal protein deposits in the heart (cardiac amyloidosis): This uncommon condition causes a protein called amyloid to accumulate in the blood and become lodged in internal organs such as the heart. Amyloid protein deposits in the heart induce permanent heart wall thickening. To fill with blood, the heart has to pump harder.
- Aerobic exercise: As a result of frequent and sustained activity, some athletes' hearts expand. This sort of enlarged heart is usually not considered an illness and does not require treatment.
- Fat around the heart: Extra fat around the heart can be seen on a chest X-ray in certain persons. There is no need for therapy unless there are additional cardiac problems present.
- An excess of iron in the body (hemochromatosis): Iron may accumulate in a variety of organs, including the heart. This can induce swelling in the lower left heart chamber.
WHAT ARE THE RISK FACTORS FOR AN ENLARGED HEART?
The risk of consequences from an enlarged heart is determined by the portion of the heart affected as well as the reason. An enlarged heart can cause the following complications:
- Heart failure: If the left lower heart chamber (left ventricle) gets enlarged, cardiac failure can develop. Heart failure occurs when the heart is unable to pump enough blood throughout the body.
- Blood clots: Blood clots can develop in the cardiac lining. A blood clot that develops on the right side of the heart has the potential to spread to the lungs (pulmonary embolism). A heart attack or stroke might occur if a clot stops blood flow.
- Heart valve leak (regurgitation): The mitral and tricuspid heart valves may not close properly due to cardiac enlargement, allowing blood to flow backward. A cardiac murmur is caused by an interruption in blood flow. Although not always dangerous, cardiac murmurs should be checked by a doctor.
- Cardiac arrest and sudden death: An enlarged heart can cause it to beat too quickly or too slowly. Arrhythmia (irregular heartbeat) can cause fainting, cardiac arrest, or sudden death.
HOW IS AN ENLARGED HEART DIAGNOSED?
A physical exam and inquiries about your symptoms and medical history are generally used to identify an enlarged heart.
The following tests may be performed to assist in the diagnosis of an enlarged heart (cardiomyopathy) and its cause:
- Blood tests: Blood tests may be used to confirm or rule out diseases that might lead to cardiac enlargement. Blood tests may be performed to assess the levels of chemicals in the blood caused by heart muscle injury if an enlarged heart is associated with chest discomfort or other indicators of a heart attack.
- X-ray of the chest: A chest X-ray can provide information on the status of the lungs and heart. If an X-ray shows that the heart is enlarged, more testing are typically required to confirm whether the enlargement is genuine and to pinpoint the cause.
- Electrocardiogram (ECG or EKG): This simple and painless examination assesses the electrical activity of the heart. Sticky patches (electrodes) are applied to the chest, as well as the arms and legs on occasion. The electrodes are linked by wires to a computer, which shows the test findings. An ECG can reveal whether the heart is pumping too quickly or too slowly. A doctor can examine signal patterns to check for evidence of thickening heart muscle (hypertrophy).
- Echocardiogram: This noninvasive examination creates pictures of the heart's size, structure, and motion using sound waves. An echocardiography visualizes blood flow through the heart chambers and assists in determining how effectively the heart is functioning.
- Stress testing or exercise tests: These tests sometimes entail walking on a treadmill or riding a stationary bike while having the heart rate monitored. Exercise testing can show how the heart reacts to physical exertion. If you are unable to exercise, you may be given drugs that have the same impact on your heart as exercise.
- Cardiac CT scan or MRI: You normally recline on a table within a doughnut-shaped machine for a heart CT scan. Inside the machine, an X-ray tube spins around your body, collecting pictures of your heart and chest.
In a cardiac MRI, you normally lie on a table inside a long tubelike equipment that generates signals that form pictures of your heart using a magnetic field and radio waves.
- Cardiac catheterization: A health care worker inserts a thin tube (catheter) into a blood vessel in the arm or groin and injects dye through the catheter into an artery in the heart. This causes the cardiac arteries to be more visible on an X-ray. Pressure inside the chambers of the heart can be evaluated during a cardiac catheterization to determine how vigorously blood pumps through the heart. A little amount of cardiac tissue is occasionally taken for examination (biopsy).
WHAT ARE THE TREATMENTS FOR AN ENLARGED HEART?
The treatment of an enlarged heart (cardiomegaly) is determined by the cause of the heart disease.
Medications
If cardiomyopathy or another form of cardiac problem is the cause of an enlarged heart, a doctor may prescribe drugs such as:
- Diuretics: These medications lower blood pressure by decreasing the quantity of salt and water in the body.
- Other blood pressure medications: To reduce blood pressure and enhance cardiac function, beta blockers, angiotensin-converting enzyme (ACE) inhibitors, or angiotensin II receptor blockers (ARBs) may be utilized.
- Blood thinners: Anticoagulants (blood thinners) may be prescribed to lower the risk of blood clots causing a heart attack or stroke.
- Heart rhythm medications: These drugs, often known as anti-arrhythmics, assist manage the heartbeat.
Surgery or other medical treatments
If drugs alone are ineffective in treating an enlarged heart, medical devices and surgery may be required.
Surgery or other treatments for an enlarged heart may include:
- Pacemaker: A pacemaker is a tiny implantable device that is generally placed around the collarbone. One or more electrode-tipped cables connect the pacemaker to the inner heart through the blood arteries. If the heart rate becomes too slow or stops, the pacemaker transmits electrical impulses to encourage the heart to beat at a regular rate.
- Heart valve surgery: If an enlarged heart is the result of heart valve disease, surgery to repair or replace the damaged valve may be required.
- Coronary bypass surgery: This open-heart surgery may be performed to redirect blood flow around a blocked artery if an enlarged heart is caused by a blockage in the coronary arteries.
- Implantable cardioverter-defibrillator (ICD): A surgeon may implant an ICD if the enlarged heart is causing major cardiac rhythm issues (arrhythmias) or if you are at danger of sudden death. An ICD is a battery-powered device that is implanted under the skin around the collarbone, much like a pacemaker. The ICD sends one or more electrode-tipped cables through veins to the heart. The cardiac rhythm is constantly monitored by the ICD. If an irregular heartbeat is detected, the ICD sends either low- or high-energy shocks to reset the cardiac rhythm.
- Left ventricular assist device (LVAD): If you suffer heart failure, your doctor may propose an implantable mechanical pump to assist your heart in pumping. An LVAD may be placed while you wait for a heart transplant or as a long-term therapy for heart failure if you are not a candidate for a heart transplant.
- Heart transplant: A heart transplant is the last choice for treating an enlarged heart that cannot be addressed in any other manner. Because of the scarcity of donor hearts, even the most seriously ill patients may have to wait a long time for a heart transplant.
HOME REMEDIES FOR AN ENLARGED HEART
If you have an enlarged heart or any form of heart disease, your doctor would most certainly advise you to live a heart-healthy lifestyle. A typical example of such a way of life would be:
- Salt reduction or avoidance
- Restricting saturated and trans fats
- Consuming a variety of veggies, fruits, and whole grain meals
- Avoiding or reducing your intake of alcohol and caffeine
- Regular exercise and weight management
- Controlling risk factors for heart disease, such as diabetes, high cholesterol, and high blood pressure