Symptoms, Causes and Health Risks of an Enlarged Heart

The Symptoms, Causes, and Health Risks of an Enlarged Heart 


An enlarged heart, also known as cardiomegaly, indicates an underlying condition – it isn’t a disease in itself.

Essentially, “cardiomegaly” refers to an imaging test highlighting the fact that a person’s heart is larger than usual. To find out what’s causing it, further tests will need conducting.

There are several causes of a cardiomegaly but most result from coronary artery disease or high blood pressure. It may improve over time but could cause congestive heart failure as blood isn’t being pumped effectively around the body. In most cases, ongoing medication is required.  

Below, we’ll go into detail about what causes a heart to become enlarged before exploring the risks and treatments involved.

What Is an Enlarged Heart?


When you have a cardiomegaly, your heart is larger than it should be. This may be due to your muscles working overtime so they’ve become enlarged or your heart’s chambers have widened.

It signifies that there’s something underlying that needs treating. This could be a heart defect that’s causing your heart to work harder than it should, e.g. high blood pressure, heart valve problems, or cardiomyopathy.

While blood will still flow normally up to a point, as the condition worsens, there will be a decline in your heart’s ability to pump blood properly. This means strokes and heart failure are some of the complications that may arise due to your heart working inefficiently.

The Types of Cardiomegaly 


The main type of enlarged hearts is dilated cardiomyopathy. This occurs when the ventricles (the walls at either side of your heart) are stretched and become thin, thus making your heart bigger.

For other types, the left ventricle thickens. This may occur through hypertrophy which is caused by high blood pressure, or it may be an inherited condition that’s known as hypertrophic cardiomyopathy.

Where the walls thicken rather than thin, the heart retains more of its pumping ability.

What Causes This Condition? 

As you can see, the enlarging of your heart may occur due to a condition you inherit from your parents (or you’re born with) or it may stem from a problem that worsens over time.

Ultimately, any disease that’s causing your heart to work harder than usual can result in a cardiomegaly. Think of it almost like working out at the gym – the harder you work, the bigger your muscles get.

Here are some of the causes:

  • High blood pressure: This means your heart is having to work hard to get blood to the rest of your body which causes the muscle to enlarge. It may cause enlargement of the left ventricle which eventually weakens your heart muscle. It may also cause your atria (the upper chambers) to enlarge.
  • Ischemic heart disease: This happens when your arteries narrow due to fatty deposits that have built up. This prevents your heart from getting enough blood, meaning it has to work harder.
  • Cardiomyopathy: There are several types of cardiomyopathy but all are progressive diseases. As they can damage the muscles of your heart, they may weaken it, reducing its ability to pump efficiently.
  • Heart valve disease: Your heart has four valves that are responsible for ensuring blood is flowing in the correct direction. Certain medications, conditions, diseases, infections, and radiation treatment for cancer can damage these valves. Therefore, blood starts to flow backward so your heart has to work harder to pump it out.
  • Heart attack: The flow of blood to the heart is completely blocked when you have a heart attack which can damage the muscle due to a lack of oxygen.
  • Thyroid disease: Your body’s metabolism is regulated by the hormones the thyroid gland produces. Both underproduction (hypothyroidism) and overproduction (hyperthyroidism) of these essential hormones can affect your heart’s size, your blood pressure, and your heart rate.
  • Arrhythmias: These are irregular heart rhythms that cause the heart to beat quickly or slowly or flutter (palpitations). Irregular rhythms may cause a backup of blood which can damage the muscle.
  • Congenital conditions: This is when you’re born with a heart disorder. There are a number of these conditions that may cause the enlargement of your heart, including patent ductus arteriosus, tetralogy of Fallot (TOF), ventricular septal defect, Ebstein’s anomaly, and an atrial septal defect.
  • Other causes: Anemia, pulmonary hypertension, myocarditis, lung disease, drug and alcohol use, and connective tissue diseases (e.g. scleroderma).

What Are the Symptoms?  


Sometimes, an enlarged heart may not cause any symptoms or signs. However, the following are key indications of the problem:

  • Swelling in the ankles or legs that are caused by fluid building up there (edema)
  • Abnormal heart rhythm (arrhythmia)
  • Shortness of breath
  • Dizziness
  • Fatigue

When should contact a doctor?

Severe warning signs include trouble catching your breath, chest pain, fainting, and pains in your jaw, neck, back, or arms. In these cases, you should seek urgent medical care as you may be having a heart attack.

Equally, if you are concerned about your heart health – you have new symptoms or signs that relate to your heart, for example – you should speak to your doctor straight away. Early detection provides the best prognosis for treatment.

What Are the Health Risks of Having an Enlarged Heart?


When you have a cardiomegaly, there are a number of complications that may arise. The type depends on the part of your heart that’s larger than it should be and what’s causing this.

However, some of the complications include:

Blood Clots

When your heart is enlarged, you may be at more risk of developing blood clots in your heart’s lining. If these get into your bloodstream, this may stem the flow of blood to essential organs, perhaps causing a stroke or heart attack.

When these clots develop on the right-hand side of your heart, there’s a risk they may move into your lungs. This may cause a pulmonary embolism, which is an incredibly dangerous condition.  

Heart Failure 

One of the most serious consequences is heart failure, the risk of which is increased when your left ventricle becomes enlarged.

Heart failure causes the weakening of your heart muscles, dilating (stretching) your ventricles so they are unable to efficiently pump blood around your body.

Heart Murmur 

Enlarged hearts may also cause two valves (the tricuspid and mitral valve) to stop closing properly as they are dilated. This leads to blood flowing backward causing what are known as “heart murmurs.” While these aren’t deemed harmful, they’re something that your doctor will want to monitor.

Cardiac Arrest 

Certain types of cardiomegaly can disrupt the beat of your heart. When these rhythms become too fast so the heart doesn’t beat correctly or too slow so blood isn’t moved properly, it can cause fainting. In severe cases, this may cause cardiac arrest and even sudden death.  

How Can It Be Treated? 

The treatment prescribed to you by your doctor depends entirely on the condition that’s causing the enlargement.

For example, high blood pressure may be treated with beta-blockers, an irregular heartbeat may be controlled with a pacemaker, heart valve problems may be treated with surgery, narrowed arteries could be cured with coronary artery bypass grafting, and heart failure may be controlled with diuretics.

To find the right treatment and to correctly diagnose your condition, a number of tests will need carrying out. These can include an echocardiogram, an electrocardiogram, blood tests, a stress test, CT scans, and MRI imaging. Conducted alongside a physical exam and an in-depth chat about your medical history and symptoms, this will allow your doctor to pinpoint what’s causing the enlargement and how best to treat the underlying cause.

Whatever treatment is recommended, there are ways you can help prevent an enlarged heart.

How Can You Prevent Cardiomegaly? 

While cardiomegaly may not be preventable if you have had the heart condition from birth, there are ways you can prevent further damage to your heart that may cause it to become enlarged.

This includes enjoying a healthy diet that’s high in vegetables and fruit, whole grains, low-fat dairy products, fish, and lean poultry. You should also try to limit your salt intake and reduce how many trans and saturated fats you have in your diet.

Also try to avoid alcohol, tobacco, and illicit drugs while starting a heart-healthy fitness regimen. This includes doing strength-training and aerobic exercises on an almost daily basis.

Finally, work with your doctor to try and get your cholesterol and blood pressure levels in check, having them monitored on a regular basis. This is especially important if you have a family history of any conditions that may result in a cardiomegaly, e.g. cardiomyopathy.

When these conditions are diagnosed early, the right steps and treatments can be put in place to prevent things from worsening.  

A Healthy and Positive Outlook 

While any symptoms and conditions relating to your heart can be frightening and worrying, understanding your heart, condition, and the best treatment options will help you lead a healthy life.

The outlook you’ll receive for your condition will depend on the underlying cause. However, by sticking to the advice and treatment plan your doctor recommends, you should be able to prevent any potential complications and keep your heart as healthy as possible.

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