The heart is a vital organ that pumps blood throughout the body. In general, its size is similar to a clenched fist. Under certain conditions, the heart can become larger than normal, a condition called cardiomegaly. While not always dangerous, an enlarged heart can signal serious heart disease.

What Causes an Enlarged Heart (Cardiomegaly)

An enlarged heart, or cardiomegaly, is not a stand-alone disease. It is a sign of other health problems. Temporary enlargement can occur with short-term stressors such as pregnancy. It may also arise from heart-related issues like valve disorders, weakened heart muscle, coronary artery disease, and rhythm disturbances. Beyond cardiac causes, alcohol use, kidney disease, HIV infection, and inherited conditions can also lead to an enlarged heart.

Symptoms of an Enlarged Heart (Cardiomegaly)

An enlarged heart often does not produce specific symptoms. Even so, the increased size can interfere with blood flow, leading to discomfort such as:

• Shortness of breath

   

• Arrhythmia or irregular heart rhythm

   

• Swelling in the legs

   

• Weight gain, especially around the abdomen

   

• Fatigue

   

• Rapid heartbeat

Symptoms vary from person to person depending on the cause and which part of the heart is enlarged. Some people notice no symptoms, while others experience mild, lingering complaints for years. As the condition progresses, shortness of breath tends to appear and may worsen over time.

If you experience the symptoms above along with chest pain, severe breathlessness, or discomfort in the upper body such as the arms, neck, jaw, and abdomen, or if you have fainted, seek medical care immediately.

Treatment Options for an Enlarged Heart

Because many factors can cause cardiomegaly, patients are advised to undergo tests to identify the underlying problem. The doctor may perform a physical exam, imaging tests, an ECG, and other necessary tests to confirm the diagnosis. Once the cause is known, treatment can be tailored accordingly, including:

1. Prescribing medications to prevent the heart enlargement from worsening

For some patients, doctors may recommend diuretics, which increase urine production and help reduce the workload on the heart. These medicines can also ease swelling in the legs. If high blood pressure contributes to the enlargement, the doctor may prescribe drugs such as ACE inhibitors and beta blockers.

Other medicines that might be used include antiarrhythmic drugs, angiotensin receptor blockers (ARBs), and anticoagulants.

2. Surgery and other procedures

If a valve problem is responsible, the doctor may suggest surgery to repair the affected valve. If blocked arteries are the cause, procedures to restore blood flow to the heart will be considered.

When rhythm disturbances are present, a pacemaker may be implanted. If the heart’s pumping function is severely weakened and medicines are no longer effective, a heart transplant may be recommended. 

3. Healthy lifestyle changes

Lifestyle factors can also contribute to heart problems. To keep the condition from getting worse, doctors often advise quitting smoking and avoiding alcohol, following a low-fat eating pattern, exercising regularly, getting adequate sleep, and practicing good stress management.

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