An enlarged heart, or cardiomegaly, is often a symptom of one of several underlying conditions. Some conditions that can cause an enlarged heart include high blood pressure, heart failure, coronary artery disease, a heart valve problem, and pregnancy. If you are diagnosed with an enlarged heart, your physician will run several tests to diagnose the underlying condition before he can decide on a treatment plan that is appropriate for you.
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Some people have no symptoms of having an enlarged heart, but many do. A common symptom is a cough, difficulty breathing, or shortness of breath, especially when lying down. This is caused by the congestion of excess fluid pooling around the lungs when the heart is enlarged. Excess fluid can also be retained in the hands, feet, ankles and legs, and can cause swelling, or edema. Some patients gain weight from the retained fluids. An enlarged heart also can cause fatigue, dizziness, and in some cases, mental confusion. Some patients experience heart palpitations or interruptions in their heart's rhythm.
Tests and Diagnosis
Often, an enlarged heart is detected during a chest X-ray. This may be taken due to a patient's symptoms of shortness of breath, or for an unrelated reason. Once an enlarged heart is noticed, several tests will be done to determine the cause.
An electrocardiogram, or EKG, is a recording of the heart's electrical activity. An echocardiogram, or ECG, is an ultrasound of the heart that can detect abnormalities. A CT scan is a series of X-rays, and an MRI is a series of magnetic images. All of these diagnostic tests can detect heart valve problems, vascular problems, and defects in the way that the heart is pumping.
The doctor may order a variety of blood tests to rule out or confirm underlying conditions. In some cases, a catheter may be run through the blood vessels to the heart. This will allow the doctor to take photos of the vessels, examine the heart valves, and, if necessary, take a biopsy of the heart muscle itself.
Depending on the underlying condition or conditions detected, your doctor will present a treatment plan. Part of the plan may be lifestyle changes that you will need to make. Examples of these changes include following a low salt and low fat diet, quitting smoking, losing weight, getting eight hours of sleep per night, and exercising. You may need to monitor your blood pressure or blood sugars at home. You also may need to weigh yourself daily to be aware of fluid retention, which can cause rapid weight gain.
Your doctor may also prescribe medications for you to take. These may include diuretics, which reduce excess fluids in the body; ACE inhibitors, which lower blood pressure; beta blockers, which can enhance the heart function and lower blood pressure, and digoxin, which can improve heart function.
Some patients may require a pacemaker or an implantable cardioverter-defibrillator. These devices monitor and regulate the pumping of the heart. Other patients, mainly those for whom medication and implantable devices are not working, may be placed on a waiting list for a heart transplant as a last resort to treat their enlarged heart.