We learn that our heart is a muscle early in our education, but because we can’t see it, we don’t always treat it that way.

While we might go to the gym to work muscles in your arms, legs, or back, we often neglect our hearts. Our hearts continue to work regardless, but sometimes they work too hard.

If you force your heart to work harder than it should, your heart, like other muscles, grows in size. While some growth isn’t a problem, a heart that gets too large becomes a cardiovascular disease known as an enlarged heart.

An enlarged heart, medically known as cardiomegaly, is a serious health issue that requires careful management by your doctor. Keep reading to learn more about cardiomegaly and how it impacts the lives of patients.

Enlarged Heart (Cardiomegaly)

Enlarged Heart (Cardiomegaly)

An enlarged heart is any heart that is bigger than the average sized human heart. The medical term for an enlarged heart is cardiomegaly.

Cardiomegaly doesn’t present the same way in every patient. If you have an enlarged heart, it might mean that your heart has:

  • Thicker than average walls
  • Wider than average chambers
  • Issues with connective tissues
  • Damaged valves
  • Blockages in one part of the heart
  • Hole in a chamber wall

In other words, the problem can impact any area of your heart.

When your heart is bigger than it should be, it doesn’t pump as efficiently as it should. Difficulties in pumping blood make you more at risk for complications like heart failure and stroke.

Is Cardiomegaly a Disease?

Is Cardiomegaly a Disease?

Cardiomegaly isn’t itself a disease. Instead, it’s a symptom of another heart condition or defect.

Some people have congenital heart defects that include cardiomegaly at birth. Others develop it over time.

Any disease that causes strain to your heart causing it to make it work harder may result in cardiomegaly. To understand the cause, remember that the heart is a muscle. Just as working other muscles in your body may cause them to grow, so does the heart.

What Are the Most Common Causes?

Causes of an enlarged heart are any issue that overworks the heart and results in thicker walls or broader chambers.

Many of the common causes are related to other cardiovascular disorders. For example, ischemic heart disease remains one of the most common conditions that result in an enlarged heart. Ischemia occurs when your body doesn’t get the nutrients or oxygen it needs to run its metabolism because your heart stops pumping blood at an appropriate rate.

High blood pressure, or hypertension, also creates the conditions for cardiomegaly. Hypertension forces your heart to pump harder than it should, which causes the muscle to grow and your heart to become enlarged.

Other Causes of Cardiomegaly

Less common causes of cardiomegaly include:

  • Anemia
  • Connective tissue diseases
  • Drug and alcohol use
  • Lung disease
  • Myocarditis
  • Pulmonary hypertension

In some cases, cardiomegaly may be a congenital issue (discovered at birth) or exercise-induced.

Symptoms of an Enlarged Heart

Symptoms of an Enlarged Heart

Some people have enlarged hearts but do not see any signs for a long time or even at all. When symptoms occur, they resemble the symptoms of other heart conditions because of struggles to pump blood.

The most common symptoms include:

  • Arrhythmia (irregular heartbeat)
  • Edema (swelling in lower extremities)
  • Shortness of breath
  • Dizziness
  • Fatigue

Cardiomegaly may cause a medical emergency like heart attacks, heart failure, or stroke. Signs of medical distress might include symptoms listed above in combination with:

  • Shortness of breath
  • Chest pain
  • Pain (arms, neck, back, jaw)
  • Fainting spells

Risk of Enlarged Heart

Because an enlarged heart is a symptom of another issue, often another heart condition or disease, the risks of cardiomegaly are similar to those of other heart issues.


High blood pressure is an important indicator of heart disease and conditions generally. When left untreated or controlled, high blood pressure, or hypertension, causes damage to your arteries. The stress caused by hypertension might damage or narrow your arteries, which may lead to an aneurysm or a bulge in a section of the vessel wall.

Risk of damage to the heart itself is another risk of hypertension. Coronary artery disease impacts the arteries supplying blood to the heart itself. When blood flows improperly to your heart muscle, it creates chest pain and may even result in arrhythmias or heart attack.

Hypertension also directly leads to an enlarged, stiff left ventricle, known as left ventricular hypertrophy.

Obesity and Sedentary Lifestyles

Obesity and sedentary lifestyles contribute to an elevated likelihood of heart disease. While obesity itself doesn’t guarantee a path to heart disease, it increases the risk of hypertension, elevated blood sugars, and hypercholesterolemia. Each of these on their own contributes to higher rates of heart diseases and conditions, which may, in turn, lead to an enlarged heart.

You’re at a higher risk for an enlarged heart as a result of congenital disease or as part of a heart condition if you also have family members, namely parents or siblings, with an enlarged heart.

Diagnosing Cardiomegaly

When you visit a doctor to discuss your symptoms, they’ll begin to explore the possibility of cardiomegaly with a physical exam.

From here, your doctor might choose to schedule a series of tests. Some, like a chest X-ray, happen in their office. In many cases, a chest X-ray is a doctor’s first port of call because it directly shows the condition of your heart walls and chambers.

Because cardiomegaly is a symptom and not a disease, your doctor will schedule a series of tests if they find evidence of enlargement. These tests uncover the cause of the enlargement to begin to treat the symptoms and the underlying condition or disease.

Tests commonly used include:

  • Echocardiogram (EKG or ECG)
  • Stress tests
  • Electrocardiogram
  • CT scans
  • Blood tests
  • MRIs

Diagnosing Congenital Defects in Unborn Babies

Pregnant mothers with heart defects or with a strong family history of heart defects like cardiomegaly may undergo a fetal echocardiogram to examine their baby’s heart.

A fetal echocardiogram is like an ultrasound in that it is a non-invasive test that creates a picture of the fetus’s heart using sound waves. Doctors recommend these for some mothers during the second trimester of their pregnancy, often between 18 and 24 weeks.

These tests aren’t used widely because an ultrasound alone shows the four chambers of the heart and its development. OB-GYNs recommend fetal echocardiograms when they detect an abnormal heartbeat or if other tests performed aren’t conclusive.

Fetal echocardiograms are also helpful tests when a doctor diagnoses a genetic disorder.

Treating an Enlarged Heart

Treating an Enlarged Heart

Doctors care for an enlarged heart by addressing the underlying cause as well as using prescription methods to reduce the enlarged part of the heart over time.

Like many heart conditions, you’ll find that doctors may recommend one or more of three courses of action to care for an enlarged heart. Doctors often prescribe:

  • Medications
  • Procedures or Surgeries
  • Lifestyle Changes


Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) both reduce your heart muscle’s size in addition to treating high blood pressure.

Other common types of medications used to improve heart function and reduce pressure on the heart and vascular system generally include:

  • Beta-blockers
  • Diuretics
  • Anti-arrhythmics
  • Anticoagulants

Procedures and Surgeries

Procedures and Surgeries

Unfortunately, not all cases respond appropriately to prescription therapies.  In these cases, you may need surgery or a procedure involving a device to manage your condition  better.

The procedure used depends on the underlying cause of your enlarged heart and the severity of your condition.

If damage to a heart valve is the cause of enlarged heart, surgery to repair or even replace the valve is a standard course of action.

Those diagnosed with dilated cardiomyopathy, a specific type of enlarged heart, mandates the use of a pacemaker to help coordination the contractions between your ventricles. A cardiovascular surgeon implants the device in your chest.

Heart failure requires more drastic measures including the use of a left ventricular assist device (LVAD) or even a heart transplant as a final resort.

Lifestyle Changes

It’s rare for a physician to provide either a prescription therapy or a surgical remedy without also mandating changes to a patient’s lifestyle. In almost all cases, a doctor will recommend that patients with an enlarged heart must:

  • Stop smoking immediately
  • Limit salt and sugar in their diets
  • Follow an appropriate program for physical activity
  • Monitor their blood pressure
  • Tighten their control on diabetes (if applicable)
  • Avoid or remove caffeine or alcohol from their diet
  • Improve their sleep patterns

A doctor may prescribe one, two, or all three of these therapies.

Protect Your Heart

If you have an enlarged heart, part of your heart muscle outgrew the preferred size and now struggles to function as intended. Doctors treat this condition by treating the underlying causes, like hypertension, to reduce the pressure on your heart.

Thankfully, some of the prescriptions used to control blood pressure and other issues also help the heart relax and even come close to its normal size.

An enlarged heart may result from one of many causes, but the most common are those within your control like hypertension. Rigorously managing your blood pressure by living a healthy lifestyle is the simplest way to avoid a whole host of heart diseases including cardiomegaly.

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