Cardiomegaly: symptoms, causes, diagnosis and treatment

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Definition of cardiomegaly

What is cardiomegaly?

Cardiomegaly is a medical term used to describe an enlarged heart. This enlarged heart can generally be seen through imaging tests, such as X-rays.

Cardiomegaly is not a disease, but it is a symptom of various other health problems, including heart disease or high blood pressure. It can also be caused by short-term stress on the body, such as pregnancy.

Then, is an enlarged heart dangerous? In some cases, cardiomegaly is a mild condition and can resolve on its own in time.

However, it is possible that some people also have permanent cardiomegaly, which will require lifelong treatment and risk of developing dangerous complications. To find out how to handle it properly, further tests are needed so that the disease that is the main cause can be overcome.

How common is this condition?

Generally, an enlarged heart can happen to anyone. However, people who have a history of high blood pressure (hypertension) or heart disease are more prone to developing this condition.

In addition, cardiomegaly is more common in elderly people than in people of younger age groups.

An enlarged heart can be treated by reducing the existing risk factors. Please discuss with your doctor for more information.

Cardiomegaly signs & symptoms

What are the symptoms of cardiomegaly?

In most cases, an enlarged heart will not show any signs or symptoms. However, if the cardiomegaly is severe enough and the heart is having trouble pumping blood, here are the symptoms you may feel:

• Hard to breathe.
• Abnormal heart rhythm (arrhythmia).
• Swelling of certain body parts, such as the legs.
• Gaining weight.
• The body feels more tired.
• Palpitations or a faster heartbeat

There may be signs and symptoms not listed above. If you have concerns about the appearance of certain symptoms, consult your doctor.

When to see a doctor?

If you have any signs or symptoms that may be related to your heart, it's best to consult a doctor immediately. An enlarged heart can be treated more easily if it is detected early.

You also need to seek emergency medical help immediately if you have other signs and symptoms that might indicate that you are having a heart attack, such as:

• Chest pain.
• Discomfort in the upper body, including the arms, back, neck, jaw, or stomach
• Heavy shortness of breath.
• Fainting.

Causes of cardiomegaly

Sometimes, the heart becomes bigger and weaker for unknown reasons. According to the Mayo Clinic, this condition is known as idiopathic cardiomegaly. However, an enlarged heart can also be caused by conditions that cause your heart to pump harder than usual or that damage your heart muscle.

In addition, congenital heart defects, damage from a heart attack, or abnormal heartbeats (arrhythmias) can also be causes of cardiomegaly.

Here are some other heart conditions or problems that have the potential to cause cardiomegaly:

• High blood pressure.
• Heart valve disease.
• Diseases related to the heart muscle or cardiomyopathy, especially types of dilated cardiomyopathy and hypertrophic cardiomyopathy.
• Cardiomyopathy during pregnancy or peripartum cardimiopathy.
• Coronary heart disease.
• High blood pressure in the arteries connecting the heart and lungs (pulmonary hypertension).
• The presence of fluid around the heart (pericardial effusion).

Health conditions not directly related to the heart

Not only those directly related to the heart, several other health conditions can also cause an enlarged heart, namely:

• Viral infection of the heart.
• Low red blood cell count (anemia).
• Thyroid disorders, such as an underactive thyroid gland (hypothyroidism) and an overactive thyroid gland (hyperthyroidism).
• Iron excess (hemochromatosis).
• Amyloidosis.
• Kidney illness.
• HIV infection.
• Alcohol or cocaine abuse.
• Genetic conditions that run in families.

Cardiomegaly risk factors

Cardiomegaly is a condition that can be suffered by people of all ages. However, there are a variety of factors that can increase your risk of developing an enlarged heart.

The following are some of the risk factors that can trigger an enlarged heart:

• Old age, due to the factor of reduced elasticity of blood vessels with age.
• Have a history of high blood pressure.
• Family history of heart disease or cardiomyopathy.
• Have had a heart attack.
• Suffering from coronary heart disease.
• Have congenital heart disease.
• Have heart valve disease.
• Being overweight or obese.
• Lack of exercise, which can increase the risk of heart disease and hypertension.

Cardiomegaly complications

Cardiomegaly can lead to more serious problems if left untreated. The following are some of the complications that may arise due to cardiomegaly:

• Blood clots that can block flow to vital organs, and can even cause a heart attack, stroke, or pulmonary embolism.
• Heart failure, because it cannot pump blood efficiently throughout the body.
• Wheezing sound in the heart or called a heart murmur.
• Cardiac arrest and sudden death.

Therefore, when you experience symptoms that are suspected of having an enlarged heart, you should immediately consult a doctor. With prompt and precise treatment, an enlarged heart can avoid possible complications.

Diagnosis & treatment of cardiomegaly

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How is cardiomegaly diagnosed?

The doctor will diagnose cardiomegaly by asking about the symptoms you are experiencing, your history of illnesses, daily activities, and your family medical history. After that, the doctor will perform a physical examination as well as a series of other tests to make an accurate diagnosis.

These tests usually include:

1. Imaging test

This test can detect your problem by showing an image of your chest. Common tests are a chest X-ray, CT scan, or magnetic resonance imaging (MRI).

2. Electrocardiogram

An electrocardiogram (EKG) records the electrical activity of your heart through electrodes attached to your skin. With this test, your doctor can diagnose heart rhythm problems and any damage that a heart attack may cause.

3. Echocardiogram

An echocardiogram uses sound waves to produce a video image of your heart. With this test, the four chambers in the heart can be evaluated and an enlarged heart can be detected.

4. Stress test

This test provides information about how well your heart is working during physical activity. You will usually be asked to walk on treadmill or stationary cycling. Meanwhile, your heart rhythm, blood pressure and breathing will be monitored.

5. Blood test

Your doctor may order blood tests to find other medical conditions that may be affecting your heart.

6. Cardiac catheterization and biopsy

In cardiac catheterization, a thin tube is inserted in the groin and travels through the blood vessels to the heart. A small piece of heart tissue (biopsy) may be removed and examined in a laboratory.

How to treat cardiomegaly?

Cardiomegaly treatment depends on the medical condition or problem that caused it. However, in general, here are some types of treatment that are usually given:

1. Medicines

If an enlarged heart is caused by cardiomyopathy or other heart conditions the doctor may recommend several medications, such as:

• Diuretics, to help lower the pressure in your arteries and heart.
• ACE inhibitors, to lower your blood pressure.
• Angiotensin receptor blockers (ARB), to lower blood pressure, especially for those who cannot take ACE inhibitors.
• Beta blockers, to lower blood pressure and improve heart function.
• Anticoagulants, to thin blood clots.
• Antiarrhythmias, to restore a normal heart rate.

If medication does not make a significant difference to the enlargement of your heart, your doctor will recommend several other medical procedures, including surgery, if needed.

2. The medical device on the heart

For certain types of enlargement of the heart such as dilated cardiomyopathy, you may need a pacemaker that regulates the contractions between the left and right ventricles of the heart. While patients with arrhythmias, a cardioverter-defibrillator (ICD) implant can be an option.

An ICD is a small device that is implanted in your chest to continuously monitor your heart rhythm and deliver electric shocks when needed to control irregular heartbeats.

If the main cause of your enlarged heart is atrial fibrillation, you may need procedures to get your heart back to its usual rhythm or to keep your heart from beating too fast.

3. Heart valve surgery

If your enlarged heart is caused by a problem with one of your heart valves, you may have to undergo surgery to repair the valve or replace it with an artificial valve.

4. Heart bypass surgery

If your enlarged heart is related to coronary heart disease, your doctor may recommend medical treatment by means of heart bypass surgery.

5. Left ventricular assist device (LVAD)

An LVAD or left ventricular assist device will be used for those of you who have heart failure and need an implanted mechanical pump, so that your heart can pump normally. With the use of an LVAD, you can temporarily improve your heart pumping while you wait for a heart transplant, or as a long-term treatment for your heart.

6. Heart transplant

In cases where medications and other medical treatments do not show any results, as well as serious damage to the heart, a heart transplant may be your last resort.

Cardiomegaly treatment at home

You need to know that cardiomegaly is a condition that can be overcome, even prevented, by non-medical means. You can start by making changes to your lifestyle, diet, and doing home remedies.

However, you should still consult with your doctor regarding home remedies that are safe and can be done alongside medical treatment from a doctor.

Here are lifestyle and home remedies that can help you deal with cardiomegaly:

• Quit smoking.
• Lose weight, check the BMI calculator to find out your ideal weight.
• Limit salt intake in your diet.
• Limit consumption of sugar.
• Eat recommended healthy foods for heart disease, including those for maintaining normal cholesterol.
• Check your blood pressure regularly.
• Do exercises or sports movements for mild heart disease, or consult a doctor.
• Avoid drinking alcohol.
• Cut back on caffeine intake.
• Try to get eight hours of sleep each day.

If you have questions, consult your doctor for the best solution that suits your health condition.