What is Cardiomegaly?
Cardiomegaly is a condition where the heart enlarges due to having to work harder to pump blood. It may be the result of heart defects or disorders. This enlarged heart is mainly seen on an imaging test such as a chest X-ray.
Causes of Cardiomegaly
Causes of an enlarged heart include:
- Hypertension or stress
- Congenital heart disease
- Complications during pregnancy
- Drug and alcohol abuse
- Viral infection of the heart
- Myocarditis (inflammation of the heart muscle)
- Thyroid problems
- Heart attack
- Kidney disorder
Symptoms of Cardiomegaly
Often cardiomegaly does not produce any symptoms, but when the heart is not able to pump blood or function properly it can cause complications such as the following:
- Swelling in the lower extremities
- Extreme tiredness
- Chest pain
- Abnormal heartbeat
- Shortness of breath
- Fainting and dizziness
Complications of Cardiomegaly
Serious complications can occur based on the cause and the part of the heart that is enlarged. These include:
- Blood clots: These often occur in people with cardiomegaly and may cause a severe stroke.
- Heart failure: The enlarged heart may result in the weakening of your heart muscles; hence the blood-pumping capacity is reduced, leading to heart failure.
- Cardiac arrest: An enlarged heart may cause a defect in the heart's electrical conduction system leading to cardiac arrest.
- Heart murmur: Having an enlarged heart may cause the heart valves to become weak or prolapse, resulting in the back-flow of blood. This produces a telltale swishing sound heard when your doctor uses a stethoscope to check your heart, known as a murmur.
Diagnosis of Cardiomegaly
If the symptoms of cardiomegaly are identified, the following diagnostic tests may be carried out:
- Echocardiogram: Sound waves produce images that help to detect any defects or enlargement in your heart.
- Blood tests: Certain substances may be present in your blood, indicating heart enlargement.
- Electrocardiogram (EKG, ECG): This test monitors the electrical activity of the heart and helps to diagnose irregular rhythms caused by heart enlargement.
- Stress test: This test records the heart’s electrical activity while you run on a treadmill.
- Imaging tests: Imaging tests like CT (Computerized Tomography) and MRI (Magnetic Resonance Imaging) use X-rays and radio waves to generate detailed images of the heart.
- Cardiac Catheterization and biopsy: A small tube is passed through the groin and guided up to the heart through blood vessels where a small biopsy is taken for testing.
Treatments for Cardiomegaly
Treatment mainly focuses on rectifying the causes of cardiomegaly and includes conservative as well as surgical treatment depending on the patient’s condition.
Medications may be prescribed including:
- Diuretics: This helps to decrease the pressure in the arteries and the heart by reducing the amount of sodium and water in the body.
- Beta-blockers: These enhance heart function by reducing blood pressure.
- Anticoagulants: These prevent heart attack or stroke by removing the blood clot and thinning the blood.
- Angiotensin-converting enzyme (ACE) inhibitors: These lower blood pressure and improve the heart’s pumping capacity.
- Anti-arrhythmics: This helps regulate an abnormal heartbeat.
- Angiotensin II receptor blockers (ARBs): These supply the benefits of ACE for patients who cannot take ACE inhibitors.
Surgery for Cardiomegaly
- Medical devices: Certain types of medical devices are introduced into the heart such as a pacemaker or implantable cardioverter-defibrillator (ICD) which coordinates the contractions between the ventricles.
- Heart valve surgery: Certain defects in the heart valves may be caused due to cardiomegaly, so surgery is sometimes necessary to replace them.
- Coronary bypass surgery (CABG): This surgery helps to clear the blockages in the coronary artery that supply oxygen-rich blood to the heart muscles.
- Left Ventricular Assist Device (LVAD): This device acts like a mechanical pump to support the weakened heart muscles in patients with heart failure.
- Heart transplant: A surgical heart transplantation may be performed on patients who fail with all other medical or surgical treatments.
Prevention of Cardiomegaly
Congenital heart conditions cannot be prevented, but damage to the heart during one’s lifetime can be avoided or mitigated by taking the following steps:
- Including fruits, vegetables, fish and whole grains as part of a healthy diet
- Reducing the intake of salt and saturated fats
- Limiting or avoiding the use of tobacco and alcohol
- Exercising regularly
- Getting regular health check-ups