Enlarged Heart

Diagnosis

To diagnose an enlarged heart (cardiomegaly), your health care provider will typically perform a physical examination and discuss your medical history and symptoms.

Tests commonly used to determine the presence and cause of an enlarged heart include:

• Blood tests: Help detect conditions that can cause heart enlargement or confirm a heart attack by identifying substances from damaged heart muscle.

• Chest X-ray: Shows the size and shape of the heart. If the heart appears enlarged, additional tests are performed to confirm.

• Electrocardiogram (ECG or EKG): Measures the heart’s electrical activity to detect abnormal rhythms or signs of thickened heart muscle.

• Echocardiogram: Uses sound waves to create images of the heart’s structure, motion, and blood flow to assess heart function.

• Exercise or stress tests: Evaluate how the heart responds to physical activity. If unable to exercise, medicines are used to mimic the effects of exercise.

• Cardiac CT scan or MRI: Creates detailed images of the heart to assess size, structure, and abnormalities.

• Cardiac catheterization: Involves inserting a thin tube through a blood vessel into the heart to measure pressure, assess blood flow, and possibly collect a tissue sample (biopsy).

Treatment

Treatment for an enlarged heart focuses on addressing the underlying cause and improving heart function.

Medications

• Diuretics: Help remove excess fluid and sodium, reducing heart workload.

• Beta blockers, ACE inhibitors, or ARBs: Lower blood pressure and improve heart function.

• Blood thinners (anticoagulants): Prevent blood clots that may lead to heart attack or stroke.

• Anti-arrhythmics: Help regulate abnormal heart rhythms.

Surgery and Procedures

If medications alone are insufficient, surgical or device-based treatments may be necessary:

• Pacemaker: Regulates heart rate and ensures consistent heartbeat.

• Implantable cardioverter-defibrillator (ICD): Monitors heart rhythm and delivers electric shocks if life-threatening arrhythmias occur.

• Heart valve surgery: Repairs or replaces damaged valves that contribute to heart enlargement.

• Coronary bypass surgery: Restores blood flow by rerouting around blocked coronary arteries.

• Left ventricular assist device (LVAD): A mechanical pump that helps the heart circulate blood, often used before or instead of a transplant.

• Heart transplant: Considered the final option when all other treatments fail, though donor heart availability can be limited.