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Cardiomegaly (Enlarged Heart)

Cardiomegaly, or an enlarged heart, is not a condition in itself but rather a sign that there may be an underlying health issue affecting the heart. It can occur due to various reasons such as pregnancy or thickening of heart walls. An enlarged heart can either be temporary or permanent, depending on the underlying cause.

High blood pressure and coronary artery disease are common causes of an enlarged heart, which can increase the risk of other heart complications like heart failure or stroke. Treatment and medication may be necessary for those with an enlarged heart, which can help manage symptoms and prevent further complications.

The heart can enlarge in two ways: through dilatation where the heart walls weaken and widen, or hypertrophy where the heart walls thicken, causing the heart to become less efficient. Those with an enlarged heart may not experience any symptoms and may only become aware of the condition through imaging tests recommended by their doctors.

Cardiomegaly Symptoms

Cardiomegaly typically doesn't cause any symptoms until it progresses to a more severe stage. If the heart is unable to pump sufficient blood, congestive heart failure symptoms may occur. These symptoms include chest pain, shortness of breath, heart palpitations, irregular heartbeat, dizziness, fainting, rapid exhaustion during physical activity, swelling, and weight gain.

Cardiomegaly Causes

The heart can enlarge due to several health conditions, including coronary artery disease, heart valve disease, cardiomyopathy, heart attack, pulmonary hypertension, infection of the heart, HIV infection, thyroid disorders, kidney disease, and genetic or inherited conditions. Pregnancy, also known as peripartum cardiomyopathy or PPCM, and high blood pressure can also lead to an enlarged heart. Other possible causes of cardiomegaly include myocarditis, pulmonary hypertension, anaemia, connective tissue diseases such as scleroderma, drug and alcohol consumption, and chronic obstructive pulmonary disease and other lung diseases (COPD).

Cardiomegaly Diagnosis

When a patient shows signs of a heart problem, the doctor will perform a physical examination and suggest tests to find out if the heart is enlarged and what might be causing it. These tests may include a chest X-ray, electrocardiogram, echocardiogram, stress test, cardiac CT or MRI, blood tests, and cardiac catheterization and biopsy. These tests help diagnose issues such as heart rhythm problems, damage from a heart attack, and blockages in the heart's arteries.

Cardiomegaly Treatment

To treat an enlarged heart, the primary focus is on treating the underlying cause. Medications are commonly used, including diuretics to reduce blood pressure and improve heart function, ACE inhibitors and angiotensin II receptor blockers to improve pumping efficiency, beta-blockers to lower blood pressure, anticoagulants to prevent blood clots, and antiarrhythmics to maintain a normal heart rhythm. In some cases, medical devices like pacemakers or implantable cardioverter-defibrillators (ICD) may be needed. Heart valve surgery or coronary bypass surgery may also be required. A left ventricular assist device (LVAD) may be implanted to help the heart pump in cases of heart failure, and a heart transplant may be considered as a last resort.

Cardiomegaly Risk factors

The following risk factors may increase a patient's chances of developing an enlarged heart:

-High blood pressure, defined as blood pressure levels exceeding 140/90 millimeters of mercury.

-Family history of cardiomyopathy. If an immediate family member, such as a parent or sibling, has had an enlarged heart, other family members may also be at risk.

-Congenital heart disease, which can increase the risk of developing an enlarged heart if the heart's structure is affected.

-Heart valve disease, which damages the four heart valves (aortic, mitral, pulmonary, and tricuspid) that direct blood flow through the heart, leading to an enlarged heart.

Cardiomegaly Complications

An enlarged heart can cause several complications, including heart failure, blood clots, heart murmurs, and cardiac arrest. An enlarged left ventricle is a severe type of heart enlargement that can increase the risk of heart failure. Additionally, an enlarged heart may make a person more susceptible to blood clots in the heart's inner lining, which can block blood flow to vital organs and cause heart attack, stroke, or pulmonary embolism. Heart murmurs may also occur when the mitral and tricuspid valves fail to close correctly, leading to the backflow of blood. In some cases, an enlarged heart can disrupt the heart's rhythm, causing it to beat too slowly or too fast, resulting in fainting, cardiac arrest, or sudden death.

Cardiomegaly Prevention

Patients may not be able to prevent congenital conditions, but they can prevent heart damage that can result in enlargement by taking the following steps:

Maintaining a heart-healthy diet that includes whole grains, fruits, vegetables, lean proteins, fish, and low-fat dairy

Limiting the intake of salt, saturated and trans fats

Avoiding tobacco and alcohol

Engaging in regular aerobic and strength-training exercises

Monitoring blood pressure and cholesterol levels and working with a doctor to lower them if they are high.