Overview
An enlarged heart, also known as cardiomegaly, is a condition where the heart appears larger than normal on any imaging test, such as a chest X-ray. It is not a disease itself but a sign of another underlying condition. Heart damage, certain types of heart disease, and temporary stress on the body, such as pregnancy, can cause an enlarged heart. Depending on the underlying condition, it may be temporary or permanent. Symptoms may include shortness of breath, irregular heart rhythm, and swelling in the belly or legs. If you have concerns about your heart or experience chest pain, severe shortness of breath, or other signs of a potential heart attack, consult your healthcare provider. Early detection and treatment of the underlying condition can help prevent complications.
Understanding the disease
Symptoms
The symptoms of an enlarged heart (cardiomegaly) may include shortness of breath, especially while lying flat or waking up short of breath, irregular heart rhythm (arrhythmia), and swelling (edema) in the belly or in the legs. However, some people may experience no symptoms at all. If you have concerns about your heart, it's important to talk to your healthcare provider. If you experience signs and symptoms of a potential heart attack, such as chest pain, discomfort in other areas of the upper body, severe shortness of breath, fainting, or sudden confusion, call 911 or your local emergency number immediately.
Risk Factors
The risk factors for developing an enlarged heart (cardiomegaly) include:
- Family history of heart muscle disease (cardiomyopathy)
- High blood pressure
- Heart diseases such as congenital heart defects or heart valve disease
- Obesity
- Lack of exercise
- Stress
- Poor dental health These factors can increase the likelihood of developing an enlarged heart. It's important to follow a healthy lifestyle, manage any underlying health conditions, and have regular health checkups to reduce the risk of an enlarged heart.
Development
Enlarged heart (cardiomegaly) can develop due to a range of factors, including heart conditions present at birth, damage from a heart attack, diseases of the heart muscle, fluid buildup around the heart, heart valve disease, high blood pressure, thyroid disorders, and excess iron in the body. Other factors that can contribute to an enlarged heart include low red blood cell count (anemia), high blood pressure in the lungs, and unusual protein deposits in the heart. In some athletes, an enlarged heart can develop as a response to frequent and prolonged exercise, but this type of enlarged heart is usually not considered a disease and doesn't require treatment.
Assessment and Diagnosis
Triage
You should see a doctor if an enlarged heart is suspected, especially if you have symptoms like shortness of breath, irregular heart rhythm, swelling in the belly or legs, chest pain, or chest discomfort. These symptoms may indicate underlying heart conditions that require medical attention. If you have concerns about your heart, it's important to talk to your healthcare provider, who can recommend the appropriate course of action, which may include further tests or referrals to a specialist like a cardiologist.
Diagnosis
To diagnose an enlarged heart (cardiomyopathy), a health care provider will typically perform a physical exam and ask questions about your symptoms and medical history. Diagnostic tests that may be conducted include blood tests to confirm or rule out conditions that cause heart enlargement, a chest X-ray to evaluate the condition of the heart and lungs, an electrocardiogram (ECG) to detect enlarged heart chambers and abnormal heart rhythms, and a cardiac MRI for detailed images of the heart. Exercise tests or stress tests may also be conducted to measure your activity tolerance and monitor your heart's response to physical exertion.
Management and Treatment
Complications
Complications of an enlarged heart (cardiomegaly) can include heart failure, blood clots, leaky heart valve (regurgitation), and fat around the heart. In severe cases, these complications can lead to further health issues such as heart attack, stroke, or sudden death. Other potential complications may include difficulty breathing, swelling in the legs or belly, and arrhythmia. It is important to seek medical attention if you experience any symptoms or concerns related to an enlarged heart.
Prevention
enlarged heart (cardiomegaly) can be prevented to some extent by following a heart-healthy lifestyle, which includes:
- Monitoring and managing high blood pressure, high cholesterol, and diabetes.
- Taking prescribed medications as directed.
- Eating a nutritious, balanced diet.
- Getting regular exercise.
- Avoiding or limiting alcohol consumption.
- Not smoking.
- Refraining from using illegal drugs. Early diagnosis and proper treatment of underlying conditions can also help prevent the enlarged heart from getting worse. It's important to inform your healthcare provider if anyone in your family has or had cardiomyopathy or other health conditions that can cause an enlarged heart.
Treatment
Treatment for an enlarged heart (cardiomegaly) depends on the underlying cause. Some common treatments include medications, medical procedures, or surgery. General treatment options for enlarged heart: Medications: Medications may be prescribed to manage underlying conditions, such as high blood pressure or abnormal heart rhythms. Diuretics may also be used to manage fluid buildup and swelling. Lifestyle modifications: Following a heart-healthy lifestyle can help prevent or manage some conditions that can lead to an enlarged heart. This includes monitoring and managing high blood pressure, high cholesterol, and diabetes; eating a nutritious, balanced diet; getting regular exercise; avoiding or limiting alcohol; not smoking; and avoiding illegal drugs. Medical procedures: If the enlarged heart is caused by a structural issue, such as a heart valve problem, a medical procedure or surgery might be necessary. Surgery: In some cases, surgery may be required to remove excess fluid around the heart, repair damaged heart tissue, or implant a device to help regulate heart rhythms. It's essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan tailored to the individual's specific condition.
Preparing for medical consultation
To prepare for an appointment regarding an enlarged heart, you should:
- Be aware of any pre-appointment restrictions and ask if there's anything you need to do in advance, such as restricting your diet.
- Write down your symptoms, including any that may seem unrelated to an enlarged heart or heart disease.
- List key personal information, such as family history of heart disease, stroke, high blood pressure, or diabetes, and major stresses or recent life changes.
- Make a list of all medications, vitamins, or supplements you're taking, including doses.
- Take a family member or friend along, if possible, to help remember any important information.
- Write down questions to ask your healthcare provider, such as:
- What is likely causing my symptoms or condition?
- Are there other possible causes for these symptoms?
- What tests do I need?
- Should I see a specialist?
- Do I need to avoid any activities or change my diet before my cardiologist appointment?
- If referred to a cardiologist, ask questions like:
- What is my diagnosis?
- What treatment do you recommend? Remember to follow a heart-healthy lifestyle, which typically includes reducing salt, limiting saturated and trans fats, eating plenty of vegetables, fruits, and whole grain foods, avoiding or limiting alcohol and caffeine, exercising regularly, and managing weight. Also, control heart disease risk factors like diabetes, high cholesterol, and high blood pressure.