Enlarged Heart

Heart enlargement (cardiomegaly) is a symptom of another disorder rather than a disease. Any enlarged heart seen on an imaging test, such as a chest X-ray, is referred to as "cardiomegaly." The ailment that is causing the enlarged heart must next be diagnosed utilizing further testing.

An enlarged heart can result from cardiac injury or specific forms of heart disease. When the body is subjected to short-term stress, such as during pregnancy, the heart may enlarge. An enlarged heart may be transient or permanent, depending on the situation. A larger heart can be treated with medication, medical treatments, or surgery.

Enlarged Heart: Causes

Damage to the heart muscle or any disease that makes the heart pump more forcefully than normal, including pregnancy, can result in an enlarged heart (cardiomegaly). Occasionally, for unexplained causes, the heart enlarges and weakens. Idiopathic cardiomyopathy is the name given to this illness.

The following conditions are linked to an enlarged heart −

  • The existing cardiac problem at birth (congenital heart defect). The heart muscle can enlarge and weaken due to issues with the heart's structure and function.

  • The harm 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.

  • Muscular diseases of the heart (cardiomyopathy). Often, cardiomyopathy causes the heart to become hard or thick. The heart may have a tougher time pumping blood as a result.

  • An accumulation of fluid in the sac around the heart (pericardial effusion). In a chest X-ray, an enlarged heart can be observed due to a build-up of fluid in the sac that houses the heart.

  • Illness of the heart valves. 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 injury to any of the valves.

  • Elevated blood pressure (hypertension). The heart may have to work harder to pump blood to the rest of the body if you have high blood pressure.

  • High blood pressure in the lungs' arteries (pulmonary hypertension). Moving blood from the lungs to the heart requires more effort from the heart. The right side of the heart may get thicker or expand as a result of the stress.

  • Low level of red blood cells (anemia). With anemia, the body doesn't have enough healthy red blood cells to transport enough oxygen to the tissues. To compensate for the blood's deficiency in oxygen, the heart must pump more blood.

  • Thyroid conditions. Heart issues, such as an enlarged heart, can result from both an underactive thyroid gland (hypothyroidism) and an overactive thyroid gland (hyperthyroidism).

  • The body has too much iron (hemochromatosis). Many organs, including the heart, can accumulate iron. The lower left heart chamber may enlarge as a result of this.

  • Abnormal protein build-up in the heart (cardiac amyloidosis). Amyloid, a protein, builds up in the blood in this uncommon condition and sticks to human organs including the heart. An unreversible thickening of the heart wall results from amyloid protein deposition. To pump blood, the heart has to work harder.

  • Aerobic activity. 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.

Enlarged Heart: Symptoms

Some people may not have any symptoms or indications of a cardiac condition called cardiomegaly. Others may exhibit the following cardiomegaly symptoms −

  • Breathlessness, especially when resting flat

  • Waking awake gasping for air

  • Abnormal cardiac beat (arrhythmia)

  • Edema (swelling) in the legs or the stomach

Enlarged Heart: Risk Factors

Several factors play an important role in the development of an enlarged heart which includes −

  • A history of heart muscle illness in the family (cardiomyopathy). Cardiomyopathy 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.

  • Elevated blood pressure. Having a blood pressure reading higher than 140/90 millimeters of mercury qualifies as this.

  • Heart conditions. Heart enlargement may be caused by any cardiac condition, including congenital heart abnormalities and heart valve dysfunction. To control heart disease, it's crucial to have a healthy lifestyle and get frequent checkups.

Enlarged Heart: Diagnosis

The diagnosis of the enlarged heart is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes

  • A chest X-ray. An X-ray of the chest can help reveal the health of the heart and lungs.

  • Electrocardiogram (ECG or EKG) (ECG or EKG). The electrical activity of the heart is measured by this rapid and painless examination.

  • Echocardiogram. Images of the size, composition, and velocity of the heart are produced during this non-invasive examination using sound waves.

  • Stress testing or exercise tests. These tests frequently entail using a treadmill or a stationary cycle while the heart rate is being monitored.

  • MRI or a cardiac CT scan. 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.

Enlarged Heart: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Conservative Treatment

Conservative treatment includes −

  • Diuretics. These medications assist decrease blood pressure by lowering salt and water levels in the body.

  • Other medicines for blood pressure. To reduce blood pressure and enhance heart health, physicians may prescribe beta blockers, ACE inhibitors, or ARBs (angiotensin II receptor blockers).

  • Clotting agents. Anticoagulants, which thin the blood, may be administered to lower the risk of blood clots that could result in a heart attack or stroke.

Surgical Treatment

Surgical treatment may be required in severe cases which include −

  • Surgery on a heart valve. Surgery may be required to replace or repair the afflicted valve if cardiac valve disease is the root cause of the enlarged heart.

  • Surgery to bypass the heart. 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.

Enlarged Heart: Prevention

Some of the measures that can help to prevent an enlarged heart include −

  • Diabetes, excessive cholesterol, and blood pressure should all be managed

  • Follow the directions on any prescription drugs

  • Consume a healthy, balanced diet

  • Exercise often

  • Limit your alcohol intake

  • Avoid smoking

  • Don't utilize illicit substances


The bulk of national healthcare costs is attributable to readmissions for heart failure. Support initiatives are in operation countrywide to reduce the number of hospitalizations caused by CHF and so ease the financial burden. With several linked disciplines and providers, these programs take a collaborative approach. Guidelines-based care, nurse discharge assistance, patient education, pharmacist medication reconciliation, and early post-discharge follow-up are a few inpatient techniques.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha


Updated on: 21-Apr-2023


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