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Enlarged Heart

Definition


Disease: Enlarged Heart Enlarged Heart
Category: Cardiovascular diseases

Disease Definition:

Cardiomegaly, also known as enlarged heart, is a symptom of another condition; it’s not a disease itself. Cardiomegaly refers to an enlarged heart seen on chest X-ray before other tests are performed to diagnose the specific condition causing the enlarged heart. In some cases, the cause of a temporarily enlarged heart could be a medical condition, including the weakening of the heart muscle, coronary artery disease, heart valve problems or abnormal heart rhythms, or sometimes it could be because of a stress on the body, such as pregnancy.

 

An enlarged heart is treatable, but it may not always be preventable. An enlarged heart is treated by correcting the underlying cause. Medications, medical procedures or surgery are some of the treatments available for an enlarged heart.
 

Work Group:


Symptoms, Causes

Symptoms:

Although in some cases an enlarged heart may not cause any signs or symptoms, however, in other cases, people with an enlarged heart may experience some of these signs and symptoms:

 

  • Cough
  • Dizziness
  • Swelling (edema)
  • Shortness of breath
  • Breathing difficulties
  • Arrhythmia, which is abnormal heart rhythm.

 

When detected early, an enlarged heart is easier to treat. A person should also talk to a doctor in case they don’t have an enlarged heart but are concerned about developing the condition, so that they can take steps to reduce their risk.

 

A person should also see a doctor in case they think there's a problem with their heart, based on new signs or symptoms they've been experiencing.

 

In case someone experiences chest pain, shortness of breath or fainting, they should seek emergency medical care because these are the signs and symptoms of a heart attack.
 

Causes:

Although in some cases the cause of an enlarged heart may not be apparent (idiopathic), but in other cases, a condition that causes the heart to pump harder than usual could cause it, such as:

 

Heart valve disease:

The four valves within the heart keep the blood flowing in the right direction. A person's heart may enlarge if their valves are damaged by infections (infectious endocarditis), a heart defect, certain medications or radiation treatments for cancer, rheumatic fever or connective tissue disorders.

 

High blood pressure:

The heart could be forced to pump harder to deliver blood to the rest of the body due to high blood pressure. This will cause the enlargement of the heart muscle.

 

Congenital heart defect:

An enlarged heart could be caused by many types of congenital heart defects, such as those that affect blood flow through the heart, and force it to pump harder.

 

Cardiomyopathy:

This condition is the thickening and stiffening of the heart muscle. Although someone may have no signs or symptoms in the early stages of cardiomyopathy, however, as the condition worsens, their heart will try to pump more blood to the body, causing its enlargement.

 

Pulmonary hypertension:

When someone has high pressure in the artery connecting their heart and lungs, the heart might need to pump harder in order to move blood between the lungs and the heart. This could lead to the enlargement of the right side of the heart.

 

Arrhythmia:

If someone has arrhythmia, it means that they have abnormal heartbeat and their heart may not pump blood as effectively as it would if their heart rhythm were normal. The heart may enlarge due to the extra work it has to do to pump blood to the body.

 

Thyroid disorders:

Heart problems, including an enlarged heart, could be the cause of hypothyroidism or hyperthyroidism.

 

Anemia:

When someone doesn't have enough healthy red blood cells to carry adequate oxygen to their tissues, it means that they have anemia. Chronic anemia could cause rapid or irregular heartbeat when left untreated. When someone's anemic, in order to make up for the lack of oxygen in the blood, their heart has to pump more blood. In some rare cases, if someone has anemia for a long time and don’t seek treatment, their heart could become enlarged.

 

Amyloidosis:

This condition is the abnormal protein circulation in the blood, which could be deposited in the heart and interfere with the heart’s function. A person's heart could enlarge in case amyloid builds up in it.

 

Hemochromatosis:

When the body doesn’t use iron properly, it could build up in various organs, such as the heart muscle. This could cause the heart muscle to weaken, and the left ventricle to enlarge.
 

Complications

Complications:

The risk of complications of an enlarged heart will depend on the underlying cause and the part of the heart that’s enlarged. An enlarged left ventricle is one of the most serious types of enlarged heart because it could cause heart failure.

 

Heart failure:

When the heart cannot pump enough blood to meet the body’s needs, heart failure occurs. Over time, when the heart can no longer keep up with the normal demands placed on it, the heart muscle starts to weaken and the ventricles dilate to the extent that the heart won’t be able to pump blood efficiently throughout the body.

 

Some of the other complications of an enlarged heart could be:

 

Heart murmur:

In people with an enlarged heart, the mitral and the tricuspid valves might not be able to close properly if they become dilated, which could cause a backflow of blood, creating sounds called hearts murmurs. Although heart murmurs should be monitored by a doctor, but they’re not necessarily harmful.

 

Blood clots:

A person may be more susceptible to forming small blood clots in the lining of their heart in case they have an enlarged heart. If these clots are pumped out of the heart and enter the circulatory system, they could block the blood flow to vital organs, including the heart and brain, which could cause a heart attack or stroke. A dangerous condition called pulmonary embolism could be caused in case clots develop on the right side of the heart and travel to the lungs.

 

Cardiac arrest and sudden death:

Disruptions in the heart’s beating rhythm could be due to some forms of enlarged heart. In some cases, the heart rhythms are too slow to move the blood, and in other cases, they are too fast to allow the heart to beat properly. In both of these cases, the abnormal heart rhythms could cause fainting, cardiac arrest or sudden death.
 

Treatments:

Treatment for an enlarged heart focuses on correcting the underlying condition.

 

MEDICATIONS:

The patient may be recommended medications to treat heart failure symptoms in case their enlarged heart is the result of cardiomyopathy or another cause of a weak heart muscle. These medications include:

 

ACE (Angiotensin-converting enzyme) inhibitors:

These drugs include ramipril , captopril , enalapril and lisinopril, which are used to lower the blood pressure and improve the heart’s pumping capability.

 

Diuretics:

One example is fuosemide. It lowers the amount of sodium and water in the body, which can help lower the pressure in the arteries and heart. Other diuretics, such as spironolactone could help prevent further scarring of the heart tissue.

 

Beta blockers:

These medications include carvedilol and metopolol, which could help lower blood pressure and improve heart function.

 

ARBs (angiotensin receptor blockers):

In case someone can’t take ACE inhibitors, they could use these medications, including valsartan and losartan .

 

Digoxin:

This drug can help in improving the pumping function of the heart and lessen the need for hospitalization for heart failure.

 

MEDICAL PROCEDURES AND SURGERIES:

Some medical procedures or surgeries might be necessary in case medications aren’t enough to treat the enlarged heart. These include:

 

Medical devices to regulate heartbeat:

A special pacemaker that coordinates the contractions between the left and right ventricle (biventricular pacing) could be necessary for people who have dilated cardiomyopathy, which is a certain type of enlarged heart. Some other options could be drug therapy or an implantable cardioverter-defibrillator (ICD) for people who are at risk of serious arrhythmias. An ICD, which could also work as a pacemaker, is a small device, about the size of a box of matches, which is implanted in the patient's chest to continuously monitor their heart rhythm and deliver electrical shocks when needed to control abnormal and rapid heartbeats. The patient might need procedures to return their heart to its regular rhythm or keep it from beating too quickly in case the enlarged heart is caused by atrial fibrillation.

 

Heart valve surgery:

In case a problem with one of the heart valves is causing the enlarged heart, a person may need surgery to remove the narrow valve or a tissue valve from a pig, cow or human-cadaver donor. In case someone has valve regurgitation, which is a condition where blood leaks backward through the valve, they could have their leaky valve surgically repaired or replaced.

 

Heart transplant:

A heart transplant could be the final option in case medications can’t control the symptoms. People who are critically ill may have to wait a long time before having a heart transplant due to the shortage of donor hearts.
 

Prognosis:

Not available

Expert's opinion

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