Enlarged Heart (Cardiomegaly): Types, Symptoms, Causes, Risks, Complications, Diagnosis, Treatment and Prevention

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X-ray of an enlarged heart

1Overview

The heart is one of the most vital organs in the body. It is where the blood is cleansed and oxygenated. It also pumps the blood throughout the body, for oxygen and other nutrients to the various tissues and cells. If the heart suddenly stopped pumping or it has a reduced capacity to pump blood, health issues will emerge.

One of the conditions a heart could experience is cardiomegaly, which is characterized by the enlargement of the heart. However, an enlarged heart is not considered a disease in itself, but a sign of another medical condition. Although the cardiomegaly may occur without any apparent cause, it can result from another condition that makes the heart work harder than it should.

As a result, the heart will become enlarged, to compensate for the work it has to do, pumping blood to the body. One of the most common culprits of having an enlarged heart is high blood pressure because it overworks the heart. Another cause is an arrhythmia, which means having an abnormal heartbeat.

In some cases, people develop an enlarged heart because of a stress on the body like a medical condition such as heart valve problems, abnormal heart rhythms, coronary artery disease and the weakening of the heart muscle.

Usually, an enlarged heart can be treated after addressing the underlying medical condition. The common treatment options include medical procedures, medications or surgery.

2Types

Dilated – The heat can become enlarged due to the dilation of the myocardium, the heart muscle. The muscle weakens and the chambers of the heart become enlarged. This type of enlarged heart may lead to heart failure.

Hypertrophic – Hypertrophic cardiomegaly occurs when there is an overgrowth of the heart muscle that can block the blood flow to the heart. People who have this condition may have a sudden and strange growth of the heart muscle fibers that make the walls very thick.

Restrictive – This type of cardiomegaly is the least common type. It occurs when the heart is infiltrated, making the heart unable to expand.

3Symptoms

Some patients with an enlarged heart may have no symptoms at all. Others may experience some degree of discomfort. When the disease progresses, that’s the time the patient may experience some symptoms. Hence, regular consultations and check-ups are important to detect an enlarged heart. The common signs and symptoms of cardiomegaly include:

  • Difficulty of breathing or shortness of breath
  • Raspy voice that may happen when lying flat or doing physical activities
  • Leg swelling or edema of the legs
  • Fatigue
  • Weight gain in the abdominal area
  • Abnormal heart rhythm or the heart skips a beat
  • Palpitations

Serious symptoms may include:

  • Fainting, near-fainting spells or loss of consciousness
  • Chest pain
  • Severe shortness of breath or difficulty of breathing

4Causes

Many factors may lead to the enlargement of the heart, which include:

Heart valve disease – The heart has four valves that prevent the backflow of blood and the mixture of oxygenated and unoxygenated blood.  If these valves become damaged due to diseases like infectious endocarditis, rheumatic fever, connective tissue disorders, some medicines, a heart defect, and radiotherapy for cancer, the heart may become enlarged.

Hypertension – Hypertension or high blood pressure will make the heart pump harder to deliver blood to the various parts of the body. As a result, the heart’s muscle will enlarge. Most of the time, the left ventricle is the one that will thicken. As a result, the heart muscles will become weak, making it harder to pump blood.

Pulmonary hypertension – High blood pressure in the artery between the lungs and the heart may lead to an enlarged heart. The heart muscle may need to pump more to move the blood between the two important organs. In this type of condition, the right ventricle is the one that becomes enlarged.

Cardiomyopathy – Disease of the heart muscle, otherwise called cardiomyopathy, may lead to the stiffening and thickening of the heart muscle. This will also make the heart exert more effort to pump blood to the body.

Anemia – A low red blood cell count or anemia is a condition wherein there are no adequate amounts of red blood cells in the body, making it harder for oxygen to reach the different cells in the body. When left untreated, anemia may make the heart compensate for the lack of red blood cells, pumping more to deliver the needed oxygen to the cells and tissues.

Pleural Effusion – Pleural effusion happens fluid accumulates around the heart, particularly in the sac or pericardium. When this happens, the heart will look enlarged and bigger than usual.

Too much iron levels – Also called hemochromatosis, excessive iron in the body may lead to the accumulation of iron in the organs, including the heart.

Thyroid disorders – When a person has either hyperthyroidism or hypothyroidism, he or she is at risk of having an enlarged heart.

Rare diseases of the heart – Some rare diseases of the heart such as amyloidosis can lead to cardiomegaly. This condition happens when abnormal proteins are found in the blood and accumulate in the heart.

5Risk Factors

Some people are at a higher risk of developing cardiomegaly because of certain factors, like:

The family history of heart disease – If the patient has a family member with a heart problem, an enlarged heart, and cardiomyopathy, he or she is a heightened risk of developing cardiomegaly.

Sedentary lifestyle – Studies have shown that having a sedentary lifestyle may increase the risk of having heart problems, including cardiomegaly.

Hypertension – People with high blood pressure may put them at risk of developing cardiomegaly.

Congenital heart disease – People who are born with the condition that affects the heart’s structures, they are at a greater risk of having an enlarged heart.

Coronary artery disease – Having blocked arteries in the heart may predispose a patient to develop an enlarged heart. This condition is characterized by the deposit of fatty plaques in the arteries, obstructing the blood flow through the heart vessels.

Heart valve disease – Having a problem with the four valves of the heart, it could lead to cardiomegaly.

Heart attackAlso called myocardial infarction, it could increase the risk of developing an enlarged heart.

The other risk factors include:

6Complications

Having an enlarged heart could lead to various complications and sometimes, serious ones. Here are the complications of having an enlarged heart.

Formation of blood clots – Having cardiomegaly may lead to the formation of blood clots in the heart’s lining. If ever these clots would enter the bloodstream, they can travel to the vital organs, leading to serious conditions such as stroke or heart attack.

Heart failure – One of the most severe complications of an enlarged heart is heart failure. The heart muscle becomes weak and in the long run, the heart becomes too weak to pump blood to the different parts of the body.

Cardiac arrest or sudden death – Some types of cardiomegaly may lead to serious complications like cardiac arrest, which can lead to death. When the heart rhythm is disrupted, it could result in fainting and severe cases, sudden death due to cardiac arrest.

Heart murmur – For individuals who have an enlarged heart, the heart valves may become damaged and as a result, this may produce sounds called heart murmurs.

7Diagnosis

First, the doctor will assess the patient’s complete medical history followed by a thorough physical examination.

Imaging tests are the best ways to detect an enlarged heart. The most common tests are:

  • Echocardiogram (ECG)
  • Chest X-ray
  • Electrocardiogram (EKG)

Further testing can be recommended, which include:

  • Stress Test
  • CT scan
  • X-ray tube
  • MRI
  • Blood tests
  • Cardiac catheterization

8Treatment

The treatment for an enlarged heart will depend on the underlying cause. Here are the commonly used treatment options for an enlarged heart or cardiomegaly.

Medicine

Medicines can help relieve the symptoms of an enlarged heart. These medicines are used to prevent blood clots, decrease blood pressure, reduce the risk of stroke or heart attack and increase the efficiency and strength of the heart muscle and contractions.

Surgery

The doctor can recommend surgery and other procedures to treat the condition such as:

Ventricular assist device (VAD) surgery – This device is an implant that can help strengthen a weak heart to pump properly and efficiently.

Coronary artery bypass grafting (CABG) – The surgery and procedure improve blood flow and reduces the risk of heart attack.

Heart transplant – This is considered the last resort when all other treatment options failed.

Heart valve surgery – This procedure may be conducted to repair a problem with any valve in the heart.

9Prevention

To prevent heart problems and disease, you can:

  • Engage in regular exercise and avoid a sedentary lifestyle
  • Eat a diet low in fat, salt, and cholesterol
  • Avoid cocaine and tobacco
  • Avoid cigarette smoking
  • Reduce stress and manage stress properly
  • Take medicines for high blood pressure and other conditions as scheduled.
  • Visit your doctor regularly and have your heart checked to detect early signs of cardiomegaly since the first stages have no symptoms.