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What is cardiomegaly?

Cardiomegaly or an enlarged heart is when your heart is abnormally thick or overly stretched, becoming larger than usual, with difficulty pumping blood.

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Cardiomegaly or an enlarged heart is when your heart is abnormally thick or overly stretched, becoming larger than usual, with difficulty pumping blood. The condition can be temporary or permanent. However, cardiomegaly is manageable, and most people can continue their normal activities of daily living.

Symptoms
An enlarged heart may not display any symptoms at all. But in some people, it may cause:  

  • Fatigue and dizziness
  • Palpitations
  • Shortness of breath
  • Edema in the abdomen, legs, and feet

If you have an enlarged heart, you are at a higher risk of developing stroke or heart failure.

Causes
When you work out, your muscles become thicker. Similarly, when your heart must work harder, it becomes thickened and enlarged. Here are conditions that can cause an enlarged heart.

  1. Ischemic heart disease
  2. Hypertension
  3. Valvular heart disease
  4. Cardiomyopathy
  5. Congenital heart disease
  6. Drug and alcohol
  7. Arrhythmia
  8. A viral myocarditis

Risk factors

  • You have an inactive lifestyle.
  • You or someone in your family have a history of heart attacks or an enlarged heart.
  • You have hypertension.
  • You smoke or drink alcohol excessively.

Diagnosis
Your doctor will ask you about your symptoms, medical history, and family medical history. Some tests may be ordered as follows:

  1. Chest X-ray for your lung and heart assessment.
  2. Electrocardiogram (EKG) to check the electrical signals of your heart.
  3. Echocardiogram to evaluate your heart size, valvular function, rhythm, and blood flow.
  4. CT scan to record a video of your heart and blood flow.
  5. MRI to create pictures of your heart in detail.

Treatment
Your doctor diagnoses the cause of an enlarged heart and manages it by medications, device implant, or surgical procedures, depending on the underlying cause. 

Medications:

  1. Diuretics
  2. Beta-blockers
  3. Renin-angiotensin-aldosterone blockade
  4. Diabetes medications

Medical or surgical procedures:

  1. Revascularization
  2. Valve repair or replacement
  3. Implantable cardioverter defibrillator (ICD) 
  4. Cardiac ablation for arrhythmias

Prevention
People with a family history of an enlarged heart should discuss with a doctor to plan for risk prevention. Lifestyle modification can be helpful.

  • Eat healthily.
  • Regular exercise for a minimum of 30 minutes every day.
  • Have adequate sleep for at least 8 hours.
  • Keep your cholesterol level and blood pressure under control.
  • Drink alcohol in moderation.
  • Stop smoking or using an illicit substance.

Complications
People with cardiomegaly are at higher risk of developing heart diseases as follows:

  • Heart failure if you have left ventricular hypertrophy. 
  • Heart attack or stroke due to blood clots.
  • Heart murmur if you have a problem with your heart valves.

Sudden cardiac death if your heart beats too fast or too slow due to cardiomegaly.

Emergency
Cardiomegaly or an enlarged heart is usually not an emergency medical condition. However, seek immediate medical care if you have the following symptoms:

  • Pain in your chest
  • Tingling sensation or pain in your jaw, neck, arms, and back.
  • Shortness of breath
  • Passing out

With proper treatment, temporary and permanent cardiomegaly are manageable, and you can have a quality life. Taking care of your health and maintaining an active lifestyle can prevent or lower the risks of developing an enlarged heart.

Article by

  • MedPark Hospital Logo
    Dr Wootipong Vootiprux A Cardiologist Specialist in Vascular Disease and Interventional Cardiology

Published: 19 Oct 2022

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