Cardiomegaly

{{Short description|Enlargement of the heart}} {{Infobox medical condition (new) | name = Cardiomegaly | synonyms = | image = Cardiomegally.PNG | caption = Cardiomegaly on chest X-ray with a pacemaker | pronounce = | field = Cardiology | symptoms = | complications = | onset = | duration = | types = Athletic heart syndrome,<ref name="Heart and Stroke Foundation of Canada" /> Ventricular hypertrophy, Atrial enlargement  | causes = Dilated cardiomyopathy,<ref name="Nature">{{Cite journal |last=Hershberger |first=Ray E |last2=Morales |first2=Ana |last3=Siegfried |first3=Jill D |date=22 September 2010 |title=Clinical and genetic issues in dilated cardiomyopathy: A review for genetics professionals |journal=Genetics in Medicine |volume=12 |issue=11 |pages=655–667 |doi=10.1097/GIM.0b013e3181f2481f |pmc=3118426 |pmid=20864896}}</ref><ref name="Luk Ahn Soor Butany 2009 pp. 219–225">{{Cite journal |last=Luk |first=A |last2=Ahn |first2=E |last3=Soor |first3=G S |last4=Butany |first4=J |date=18 November 2008 |title=Dilated cardiomyopathy: a review |journal=Journal of Clinical Pathology |volume=62 |issue=3 |pages=219–225 |doi=10.1136/jcp.2008.060731 |pmid=19017683 |s2cid=28182534}}</ref><ref name="WebMD 2019">{{Cite web |date=2019-01-30 |title=What Is an Enlarged Heart (Cardiomegaly)? |url=https://www.webmd.com/heart-disease/guide/enlarged-heart-causes-symptoms-types |access-date=2019-03-29 |website=WebMD}}</ref><ref name="Lee Oh Lee Koh 2014 p=84">{{Cite journal |last=Lee |first=Ji Eun |last2=Oh |first2=Jin-Hee |last3=Lee |first3=Jae Young |last4=Koh |first4=Dae Kyun |date=2014 |title=Massive Cardiomegaly due to Dilated Cardiomyopathy Causing Bronchial Obstruction in an Infant |journal=Journal of Cardiovascular Ultrasound |volume=22 |issue=2 |pages=84–7 |doi=10.4250/jcu.2014.22.2.84 |pmc=4096670 |pmid=25031799}}</ref> Hypertrophic cardiomyopathy.<ref name="Heart and Stroke Foundation of Canada">{{Cite web |title=Enlarged heart |url=https://www.heartandstroke.ca:443/en/heart/conditions/enlarged-heart/ |url-status=dead |archive-url=https://web.archive.org/web/20190329154602/https://www.heartandstroke.ca/en/heart/conditions/enlarged-heart/ |archive-date=2019-03-29 |access-date=2019-03-29 |website=Heart and Stroke Foundation of Canada |quote=Types...Hypertrophic cardiomyopathy, Left ventricular hypertrophy (LVH), Intense, prolonged athletic training}}</ref><ref name="Marian Braunwald pp. 749–770">{{Cite journal |last=Marian |first=Ali J. |last2=Braunwald |first2=Eugene |date=15 September 2017 |title=Hypertrophic Cardiomyopathy |journal=Circulation Research |volume=121 |issue=7 |pages=749–770 |doi=10.1161/CIRCRESAHA.117.311059 |pmc=5654557 |pmid=28912181}}</ref><ref name="Maron p. ">{{Cite journal |last=Maron |first=Martin S |date=1 February 2012 |title=Clinical Utility of Cardiovascular Magnetic Resonance in Hypertrophic Cardiomyopathy |journal=Journal of Cardiovascular Magnetic Resonance |volume=14 |issue=1 |pages=13 |doi=10.1186/1532-429X-14-13 |pmc=3293092 |pmid=22296938 |doi-access=free}}</ref><ref name="Almog Weissberg Herczeg Pajewski 1977 pp. 116–120">{{Cite journal |last=Almog |first=C |last2=Weissberg |first2=D |last3=Herczeg |first3=E |last4=Pajewski |first4=M |date=1 February 1977 |title=Thymolipoma simulating cardiomegaly: a clinicopathological rarity. |journal=Thorax |volume=32 |issue=1 |pages=116–120 |doi=10.1136/thx.32.1.116 |pmc=470537 |pmid=138960}}</ref><ref name="Hou Kang 2012 pp. 337–354">{{Cite journal |last=Hou |first=Jianglong |last2=Kang |first2=Y. James |date=September 2012 |title=Regression of pathological cardiac hypertrophy: Signaling pathways and therapeutic targets |journal=Pharmacology & Therapeutics |volume=135 |issue=3 |pages=337–354 |doi=10.1016/j.pharmthera.2012.06.006 |pmc=3458709 |pmid=22750195}}</ref> | risks = | diagnosis = Hypertrophic cardiomyopathy screening<ref name="Luis Fuentes Wilkie 2017 pp. 1041–1054">{{Cite journal |last=Luis Fuentes |first=Virginia |last2=Wilkie |first2=Lois J. |date=September 2017 |title=Asymptomatic Hypertrophic Cardiomyopathy |url=https://researchonline.rvc.ac.uk/id/eprint/10891/1/10891.pdf |journal=Veterinary Clinics of North America: Small Animal Practice |volume=47 |issue=5 |pages=1041–1054 |doi=10.1016/j.cvsm.2017.05.002 |pmid=28662873}}</ref><ref name="Maron Maron 2013 pp. 242–255">{{Cite journal |last=Maron |first=Barry J |last2=Maron |first2=Martin S |date=January 2013 |title=Hypertrophic cardiomyopathy |journal=The Lancet |volume=381 |issue=9862 |pages=242–255 |doi=10.1016/S0140-6736(12)60397-3 |pmid=22874472 |s2cid=38333896}}</ref> | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} '''Cardiomegaly''' (sometimes '''megacardia''' or '''megalocardia''') is a medical condition in which the heart becomes enlarged. It is more commonly referred to simply as "having an '''enlarged heart'''". It is usually the result of underlying conditions that make the heart work harder, such as obesity, heart valve disease, high blood pressure (hypertension), and coronary artery disease. Cardiomyopathy is also associated with cardiomegaly.<ref name="auto">{{Cite web |title=Overview of Cardiomyopathies |url=https://www.lecturio.com/concepts/overview-of-cardiomyopathies/ |access-date=25 August 2021 |website=The Lecturio Medical Concept Library}}</ref>

Cardiomegaly can be serious and can result in congestive heart failure. Recent studies suggest that cardiomegaly is associated with a higher risk of sudden cardiac death.<ref name="ncbi">{{Cite journal |last=Tavora F |display-authors=etal |year=2012 |title=Cardiomegaly is a common arrhythmogenic substrate in adult sudden cardiac deaths and is associated with obesity. |journal=Pathology |volume=44 |issue=3 |pages=187–91 |doi=10.1097/PAT.0b013e3283513f54 |pmid=22406485 |s2cid=25422195}}</ref>

Cardiomegaly may diminish over time, but many people with an enlarged heart (dilated cardiomyopathy) need lifelong medication.<ref name="webmd">{{Cite web |title=What Is an Enlarged Heart (Cardiomegaly)? |url=http://www.webmd.com/heart-disease/guide/enlarged-heart-causes-symptoms-types |website=WebMD}}</ref> Having a family history of cardiomegaly may indicate an increased risk for this condition.<ref name="MayoClinic">{{Cite web |title=Enlarged heart - Symptoms and causes |url=http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/risk-factors/con-20034346 |access-date=19 March 2018 |website=mayoclinic.org}}</ref>

Lifestyle factors that can help prevent cardiomegaly include eating a healthy diet, controlling blood pressure, exercise, medications, and not abusing anabolic-androgenic steroids, alcohol and cocaine.<ref name="MayoClinic" />

==Signs and symptoms== {{further|Cardiogenic shock}} For many people, cardiomegaly is asymptomatic. For others, if the enlarged heart begins to affect the body's ability to pump blood, then symptoms associated with congestive heart failure may arise, including:<ref name="MayoClinic" /> * Heart palpitations – the irregular beating of the heart, usually associated with a valve * Severe shortness of breath (especially when physically active) * Chest pain * Coughing, when lying down * Fatigue * Leg swelling * Increased abdominal girth * Weight gain * Edema – swelling<ref>{{Cite web |last=Mayo Clinic Staff |date=January 16, 2020 |title=Enlarged heart |url=https://www.mayoclinic.org/diseases-conditions/enlarged-heart/symptoms-causes/syc-20355436 |access-date=May 12, 2020 |website=Mayo Clinic}}</ref> * Fainting<ref name="MayoClinic" />

==Causes== The causes of cardiomegaly are not well understood and many cases have no known cause. Lifestyle-related risk factors include tobacco use and high cholesterol, high blood pressure, and some types of diabetes. Non-lifestyle risk factors include a family history of cardiomegaly, coronary artery disease (CAD), congenital heart failure, atherosclerotic disease, valvular heart disease, exposure to cardiac toxins, sleep-disordered breathing (such as sleep apnea), and sustained cardiac arrhythmias.{{cn|date=May 2025}}

Research and the evidence of previous cases link the following (below) as possible causes of cardiomegaly.{{citation needed|date=February 2021}}

The most common causes of cardiomegaly are congenital (patients are born with the condition based on a genetic inheritance), high blood pressure (which can enlarge the left ventricle causing the heart muscle to weaken over time), and coronary artery disease. In the latter case, the disease creates blockages in the heart's blood supply, leading to tissue death which causes other areas of the heart to work harder, causing the heart to expand in size.{{citation needed|date=February 2021}}

Other possible causes include: * Heart valve disease{{cn|date=May 2025}} * Cardiomyopathy (disease of the heart muscle)<ref name="auto"/> * Pulmonary hypertension<ref>{{Cite web |title=Pulmonary Hypertension |url=https://www.lecturio.com/concepts/pulmonary-hypertension/ |access-date=25 August 2021 |website=The Lecturio Medical Concept Library}}</ref> * Pericardial effusion (fluid around the heart)<ref>{{Cite web |title=Pericardial Effusion and Cardiac Tamponade |url=https://www.lecturio.com/concepts/pericardial-effusion-and-cardiac-tamponade/ |access-date=25 August 2021 |website=The Lecturio Medical Concept Library}}</ref> * Thyroid Disorders{{cn|date=May 2025}} * Hemochromatosis (excessive iron in the blood)<ref>{{Cite web |title=Hereditary Hemochromatosis |url=https://www.lecturio.com/concepts/hereditary-hemochromatosis/ |access-date=25 August 2021 |website=The Lecturio Medical Concept Library}}</ref> * Amyloidosis<ref name="MayoClinic" /> * Chagas disease, an important cause of cardiomegaly in Latin America<ref name="bestetti2016">{{Cite journal |last=Bestetti |first=Reinaldo B. |date=Nov 2016 |title=Chagas Heart Failure in Patients from Latin America |journal=Card Fail Rev |volume=2 |issue=2 |pages=90–94 |doi=10.15420/cfr.2016:14:2 |pmc=5490952 |pmid=28785459}}</ref> * Viral infection of the heart{{cn|date=May 2025}} * Pregnancy, with enlarged heart developing around the time of delivery (peripartum cardiomyopathy){{cn|date=May 2025}} * Kidney disease requiring dialysis{{cn|date=May 2025}} * Alcohol or cocaine abuse{{cn|date=May 2025}} * HIV infection<ref name="webmd" /> * Diabetes<ref>http://www.ddcmultimedia.com/doqit/Care_Management/CM_HeartFailure/L1P4.html{{dead link|date=November 2016 |bot=InternetArchiveBot |fix-attempted=yes }}</ref>

Cardiomegaly can also occur non-pathologically as part of athletic heart syndrome (AHS) in individuals who frequently engage in high-intensity physical exercise, for instance endurance athletes and other individuals who exercise for more than 1 hour daily.<ref name="Fishbein11">{{Cite journal |last=Fishbein |first=Gregory A. |last2=Fishbein |first2=Michael C. |date=1 September 2011 |title=When is Having a Big Heart a Problem? |url=https://journals.sagepub.com/doi/10.23907/2011.024 |journal=Academic Forensic Pathology |volume=1 |issue=2 |pages=188–193 [191] |doi=10.23907/2011.024 |access-date=27 February 2025|url-access=subscription }}</ref> AHS is a result of physiological cardiac remodeling, which is a natural adaptation to frequent physical exercise and a high level of physical fitness.<ref name="WeinerBaggish12">{{Cite journal |last=Weiner |first=Rory B. |last2=Baggish |first2=Aaron L. |date=3 March 2012 |title=Exercise-Induced Cardiac Remodeling |url=https://www.sciencedirect.com/science/article/pii/S0033062012000072#s0035 |journal=Progress in Cardiovascular Diseases |language=en |publisher=Elsevier |volume=54 |issue=5 |pages=380–386 [384] |doi=10.1016/j.pcad.2012.01.006 |issn=0033-0620 |pmid=22386288 |access-date=27 February 2025|url-access=subscription }}</ref> Cardiomegaly due to AHS is usually benign and reversible, but it is important that athletes with suspected AHS undergo screening to rule out potentially life-threatening underlying heart problems.<ref name="PalermiEtAl23">{{Cite journal |last=Palermi |first=Stefano |last2=Cavarretta |first2=Elena |last3=D'Ascenzi |first3=Flavio |last4=Castelletti |first4=Silvia |last5=Ricci |first5=Fabrizio |last6=Vecchiato |first6=Marco |last7=Serio |first7=Alessandro |last8=Cavigli |first8=Luna |last9=Bossone |first9=Eduardo |last10=Limongelli |first10=Giuseppe |last11=Biffi |first11=Alessandro |last12=Monda |first12=Emanuele |last13=La Gerche |first13=Andre |last14=Baggish |first14=Aaron |last15=D'Andrea |first15=Antonello |display-authors=1 |date=19 May 2023 |title=Athlete's Heart: A Cardiovascular Step-By-Step Multimodality Approach |journal=Reviews in Cardiovascular Medicine |language=en |publisher=IMR Press |volume=24 |issue=5 |page=151 |doi=10.31083/j.rcm2405151 |issn=1530-6550 |pmc=11273059 |pmid=39076743 |hdl-access=free |hdl=11573/1718941}}</ref><ref name="McKelvie24">{{Cite web |last=McKelvie |first=Robert S. |title=Athlete's Heart |url=https://www.msdmanuals.com/professional/cardiovascular-disorders/sports-and-the-heart/athlete-s-heart?query=athletes%20heart |url-status=live |archive-url=https://web.archive.org/web/20250227105326/https://www.msdmanuals.com/professional/cardiovascular-disorders/sports-and-the-heart/athlete-s-heart?query=athletes%20heart#Prognosis_v941950 |archive-date=27 February 2025 |access-date=27 February 2025 |website=MSD Manual: Professional Version |publisher=Merck & Co. |language=en}}</ref>

In recent years, after the deaths of several rock and metal drummers from drug overdoses, autopsies have revealed that they were suffering from cardiomegaly, which may have been worsened by a mix of drug use and the cardiovascular effects of the exertion involved in rock drumming. Examples of such cases include Jimmy 'The Rev' Sullivan (Avenged Sevenfold) and Taylor Hawkins (Foo Fighters).<ref name="Wiederhorn10">{{Cite magazine |last=Wiederhorn |first=Jon |date=9 June 2010 |title=Avenged Sevenfold Drummer Died of Accidental Overdose |url=https://www.rollingstone.com/music/music-news/avenged-sevenfold-drummer-died-of-accidental-overdose-92863/ |url-access=subscription |archive-url=https://archive.today/20120524092840/http://www.rollingstone.com/music/news/avenged-sevenfold-drummer-died-of-accidental-overdose-20100609 |archive-date=24 May 2012 |access-date=27 February 2025 |magazine=Rolling Stone}}</ref><ref name="Berry22">{{Cite news |last=Berry |first=Sarah |date=1 April 2022 |title=Taylor Hawkins died with a heavy heart, but what does that mean? |url=https://www.smh.com.au/lifestyle/health-and-wellness/taylor-hawkins-died-with-a-heavy-heart-but-what-does-that-mean-20220329-p5a8un.html |url-access=limited |archive-url=https://web.archive.org/web/20240623202843/https://www.smh.com.au/lifestyle/health-and-wellness/taylor-hawkins-died-with-a-heavy-heart-but-what-does-that-mean-20220329-p5a8un.html |archive-date=23 June 2024 |access-date=27 February 2025 |work=The Sydney Morning Herald}}</ref>

==Mechanism== Within the heart, the working fibers of the myocardial tissue increase in size. As the heart works harder the actin and myosin filaments experience less overlap which increases the size of the myocardial fibers. If there is less overlap of the protein filaments within the sarcomeres of the muscle fibers, they will not be able to effectively pull on one another. If the heart tissue gets too big and stretches too far, then those filaments cannot effectively pull on one another to shorten the muscle fibers, impacting the heart's sliding filament mechanism. If fibers cannot shorten properly and the heart cannot contract properly, then blood cannot be effectively pumped to the lungs to be re-oxygenated or to the body to deliver oxygen to the working tissues of the body.{{citation needed|date=February 2021}}

An enlarged heart is more susceptible to forming blood clots in the heart lining. These clots can form elsewhere in the body, potentially disrupting blood supply to other organs.{{cn|date=May 2025}}

==Diagnosis== Many techniques and tests are used to diagnose an enlarged heart. These tests can be used to see how efficiently the heart is pumping, determine which chambers of the heart are enlarged, look for evidence of prior heart attacks and determine if a person has congenital heart disease.<ref>{{Cite book |title=Cardiomegaly |url=https://www.ncbi.nlm.nih.gov/sites/books/NBK542296/ |publisher=NCBI Bookshelf |access-date=2025-05-29}}</ref>

{{anchor|Cardiothoracic ratio}}[[File:Cardiothoracic ratio.jpg|thumb|220px|Cardiothoracic ratio = <math>{MRD + MLD \over ID}</math> <br>where:<ref>{{Cite web |title=Chest Measurements |url=http://www.ohsu.edu/xd/education/schools/school-of-medicine/departments/clinical-departments/diagnostic-radiology/pediatric-radiology-normal-measurements/chest-measurements.cfm |access-date=2017-01-13 |website=Oregon Health & Science University}}</ref> <br>MRD = greatest perpendicular diameter from midline to right heart border <br>MLD = greatest perpendicular diameter from midline to left heart border <br>ID = internal diameter of chest at level of right hemidiaphragm]] * '''Chest X-ray''': X-ray images help to visualize the condition of the lungs and heart. If the heart is enlarged on an X-ray, other tests will usually be needed to find the cause. A useful measurement on X-ray is the cardio-thoracic ratio, which is the transverse diameter of the heart, compared with that of the thoracic cage.<ref>{{Cite web |title=cardiothoracic ratio |url=http://medical-dictionary.thefreedictionary.com/cardiothoracic+ratio |access-date=19 March 2018 |website=thefreedictionary.com}}</ref> These diameters are taken from PA chest x-rays using the widest point of the chest and measuring as far as the lung pleura, rather than lateral skin margins. If the ratio is greater than 50%, pathology is suspected.<ref name="JustinZaman2007">{{Cite journal |last=Justin |first=M |last2=Zaman |first2=S |last3=Sanders |first3=J. |last4=Crook |first4=A. M |last5=Feder |first5=G. |last6=Shipley |first6=M. |last7=Timmis |first7=A. |last8=Hemingway |first8=H. |date=1 April 2007 |title=Cardiothoracic ratio within the 'normal' range independently predicts mortality in patients undergoing coronary angiography |journal=Heart |volume=93 |issue=4 |pages=491–494 |doi=10.1136/hrt.2006.101238 |pmc=1861494 |pmid=17164481}}</ref> The measurement was first proposed in 1919 to screen military recruits. A newer approach to using these x-rays for evaluating heart health takes the ratio of heart area to chest area and has been called the two-dimensional cardiothoracic ratio.<ref name="Browne2004">{{Cite journal |last=Browne |first=Ronan F. J. |last2=O'Reilly |first2=Geraldine |last3=McInerney |first3=David |date=18 February 2004 |title=Extraction of the Two-Dimensional Cardiothoracic Ratio from Digital PA Chest Radiographs: Correlation with Cardiac Function and the Traditional Cardiothoracic Ratio |journal=Journal of Digital Imaging |volume=17 |issue=2 |pages=120–123 |doi=10.1007/s10278-003-1900-3 |pmc=3043971 |pmid=15188777}}</ref> * '''Electrocardiogram''': This test records the electrical activity of the heart through electrodes attached to the skin. Impulses are recorded as waves and displayed on a monitor or printed on paper. This test helps diagnose heart rhythm problems and assess the damage to a person's heart from a heart attack.<ref>{{Cite journal |title=Electrocardiographic diagnosis of chamber enlargement |journal=Journal of the American College of Cardiology |date=1986 |volume=7 |issue=3 |pages=638–651 |doi=10.1016/S0735-1097(86)80207-8 |pmid=2936876 |url=https://www.jacc.org/doi/10.1016/S0735-1097(86)80207-8}}</ref> * '''Echocardiogram''': This test uses sound waves to produce a video image of the heart. With this test, the four chambers of the heart can be evaluated. {{cn|date=May 2025}} * '''Stress test''': A stress test, also called an exercise stress test, provides information about how well the heart works during physical activity. It usually involves walking on a treadmill or riding a stationary bike while heart rhythm, blood pressure, and breathing are monitored.{{cn|date=May 2025}} * '''Cardiac computerized tomography''' (CT) or '''magnetic resonance imaging''' (MRI). These techniques create images of the heart for inspection.<ref>{{cite journal |last1=Amin |first1=Hina |last2=Siddiqui |first2=Waqas J. |title=Cardiomegaly |journal=StatPearls [Internet] |date=20 November 2022 |url=https://www.ncbi.nlm.nih.gov/sites/books/NBK542296/ |publisher=StatPearls Publishing |language=en}}</ref> * '''Blood tests''': Blood tests may be ordered to check the levels of substances in the blood that may show a heart problem. Blood tests can also help rule out other conditions.<ref>{{cite journal |last1=Amin |first1=Hina |last2=Siddiqui |first2=Waqas J. |title=Cardiomegaly |journal=StatPearls [Internet] |date=20 November 2022 |url=https://www.ncbi.nlm.nih.gov/sites/books/NBK542296/ |publisher=StatPearls Publishing |language=en}}</ref>

thumb|Histopathology of (a) normal myocardium and (b) myocardial hypertrophy. Scale bar indicates 50 μm. thumb|Weight of the heart versus the body<ref name="KumarLiestøl2014">{{Cite journal |last=Kumar |first=Neena Theresa |last2=Liestøl |first2=Knut |last3=Løberg |first3=Else Marit |last4=Reims |first4=Henrik Mikael |last5=Mæhlen |first5=Jan |year=2014 |title=Postmortem heart weight: relation to body size and effects of cardiovascular disease and cancer |journal=Cardiovascular Pathology |volume=23 |issue=1 |pages=5–11 |doi=10.1016/j.carpath.2013.09.001 |issn=1054-8807 |pmid=24121021}}</ref> * '''Cardiac catheterization and biopsy''': In this procedure, a catheter is inserted into the groin and threaded through the blood vessels to the heart, where a biopsy of the heart can be extracted for laboratory analysis.<ref name="MayoClinic" /> * '''Autopsy:''' Cardiomegaly is indicated if the heart weighs more than >399 grams in women and >449 grams in men.<ref name="Tracy2011">{{Cite journal |last=Tracy |first=Richard Everett |date=2011 |title=Association of Cardiomegaly with Coronary Artery Histopathology and its Relationship to Atheroma |journal=Journal of Atherosclerosis and Thrombosis |volume=18 |issue=1 |pages=32–41 |doi=10.5551/jat.5090 |pmid=20953090 |doi-access=free}}</ref>

== Classification == Cardiomegaly can be classified by the main enlarged location of the heart, and/or by the structure of the enlargement.{{cn|date=May 2025}}

Specific subtypes include athletic heart syndrome, which is a non-pathological condition commonly seen in sports medicine in which the heart is enlarged, and the resting heart rate is lower than normal.{{cn|date=May 2025}}

=== By enlarged location === * Ventricular hypertrophy ** Left ** Right / Cor pulmonale * Atrial enlargement ** Left ** Right

=== Structure of enlargement === Dilated cardiomyopathy is the most common type of cardiomegaly. In this condition, the walls of the left and/or right ventricles of the heart become thin and stretched.<ref>{{Cite web |title=Dilated Cardiomyopathy |url=https://www.lecturio.com/concepts/dilated-cardiomyopathy/ |access-date=25 August 2021 |website=The Lecturio Medical Concept Library}}</ref>

In the other types, the heart's left ventricle becomes abnormally thick. Hypertrophy is usually what causes left ventricular enlargement. Hypertrophic cardiomyopathy is typically an inherited condition.<ref>{{Cite web |title=Hypertrophic Cardiomyopathy |url=https://www.lecturio.com/concepts/hypertrophic-cardiomyopathy/ |access-date=25 August 2021 |website=The Lecturio Medical Concept Library}}</ref>

==Treatment== Treatments include a combination of medications and medical/surgical procedures. Below are some of the treatment options:

=== Medications === * Diuretics: to lower the amount of sodium and water in the body, which can help lower the pressure in the arteries and heart.<ref>{{Cite web |date=October 2020 |title=Cor Pulmonale |url=https://www.lecturio.com/concepts/cor-pulmonale/ |access-date=10 July 2021 |website=The Lecturio Medical Concept Library}}</ref> * Angiotensin-converting enzyme (ACE) inhibitors: to lower blood pressure and improve pumping ability.<ref>{{Cite book |title=Kaplan's Essentials of Cardiac Anesthesia |publisher=Elsevier |year=2018 |isbn=978-0-323-49798-5 |doi=10.1016/c2012-0-06151-0 |quote=Mechanisms of Action:ACE inhibitors act by inhibiting one of several proteases responsible for cleaving the decapeptide Ang I to form the octapeptide Ang II. Because ACE is also the enzyme that degrades bradykinin, ACE inhibitors increase circulating and tissue levels of bradykinin (Fig. 8.4).}}</ref> * Angiotensin receptor blockers (ARBs): to provide the benefits of ACE inhibitors for patients with ACE inhibitor issues.<ref>{{Cite web |title=Management of Hypertension in Chronic Heart Failure |url=https://www.medscape.com/viewarticle/703609 |access-date=2019-02-03 |website=Today on Medscape}}</ref> * Beta blockers: to lower blood pressure and improve heart function.<ref>{{Cite journal |vauthors=Freemantle N, Cleland J, Young P, Mason J, Harrison J |date=June 1999 |title=beta Blockade after myocardial infarction: systematic review and meta regression analysis |journal=BMJ |volume=318 |issue=7200 |pages=1730–7 |doi=10.1136/bmj.318.7200.1730 |pmc=31101 |pmid=10381708}}</ref> * Digoxin: to help improve heart pumping function and lessen the need for hospitalization for heart failure.<ref>{{Cite web |title=Digoxin |url=https://www.drugs.com/monograph/digoxin.html |url-status=live |archive-url=https://web.archive.org/web/20161221004328/https://www.drugs.com/monograph/digoxin.html |archive-date=21 December 2016 |access-date=8 December 2016 |publisher=The American Society of Health-System Pharmacists}}</ref> * Anticoagulants: to reduce blood clot risk.<ref>{{Cite web |date=2018-02-06 |title=Anticoagulant medicines |url=https://www.nhs.uk/conditions/anticoagulants/ |access-date=2020-01-23 |website=nhs.uk |language=en}}</ref> * Anti-arrhythmics: to maintain normal heart rhythm.{{cn|date=May 2025}}

=== Devices to regulate heartbeat === * Pacemaker: Coordinates contractions between ventricles. In people at risk of arrhythmias, drug therapy or an implantable cardioverter-defibrillator (ICD).{{cn|date=May 2025}} * ICDs: Small devices implanted in the chest to monitor heart rhythm and deliver electrical shocks to control abnormal heartbeats. The devices can also work as pacemakers.{{cn|date=May 2025}}

=== Surgical procedures === * Valve surgery: If an enlarged heart is caused by a problem with a heart valve, surgery can remove the valve and replace it with either an artificial valve or a tissue valve from a pig, cow or deceased human donor. If blood leaks backward through a valve (valve regurgitation), the leaky valve may be surgically repaired or replaced.{{cn|date=May 2025}} * Coronary bypass surgery: to address coronary artery disease, which can lead to an enlarged heart. * Left ventricular assist device: (LVAD): to help a weak heart pump, potentially while waiting for a heart transplant or as a long-term treatment for heart failure. * Heart transplant: to provide a final option after other treatments fail.<ref name="MayoClinic" />

== Consequences == The exact mortality rate for people with cardiomegaly is unknown. However, many people live for a long time with an enlarged heart and, if detected early, treatment can help improve the condition and prolong their lives.<ref name="MayoClinic" /> * Heart failure: One of the most serious types of enlarged heart, an enlarged left ventricle, increases the risk of heart failure. In heart failure, the heart muscle weakens, and the ventricles stretch (dilate) to the point that the heart can't pump blood efficiently throughout the body.{{cn|date=May 2025}} * Blood clots: If clots enter the bloodstream, they can block blood flow to vital organs, possibly causing a heart attack or stroke. Clots that develop on the right side of the heart may travel to the lungs, a dangerous condition called a pulmonary embolism.{{cn|date=May 2025}} * Heart murmur: Two of the heart's four valves – the mitral and tricuspid valves – may become dilated and not close properly, leading to a backflow of blood. This flow creates sounds called heart murmurs.{{cn|date=May 2025}} * Cardiomegaly may be a temporary condition that can resolve on its own.{{cn|date=May 2025}}

== Recommended lifestyle changes == The following recommendations are:{{cn|date=May 2025}} * Smoking cessation * Limiting alcohol and caffeine intake * Maintaining a healthy weight * Increasing fruits and vegetables in a daily diet * Limiting consumption of high-fat and/or high-sugar foods * Getting adequate restful sleep

==References== {{reflist}}

==Further reading== * {{Cite book |last=Amin |first=Hina |title=StatPearls |last2=Siddiqui |first2=Waqas J. |date=2019 |publisher=StatPearls Publishing |chapter=Cardiomegaly |pmid=31194436 |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK542296/}} * {{Cite journal |last=Ampanozi |first=Garyfalia |last2=Krinke |first2=Eileen |last3=Laberke |first3=Patrick |last4=Schweitzer |first4=Wolf |last5=Thali |first5=Michael J. |last6=Ebert |first6=Lars C. |date=1 September 2018 |title=Comparing fist size to heart size is not a viable technique to assess cardiomegaly |journal=Cardiovascular Pathology |volume=36 |pages=1–5 |doi=10.1016/j.carpath.2018.04.009 |pmid=29859507 |s2cid=44086023}} * {{Cite journal |last=Agostoni |first=PierGiuseppe |last2=Cattadori |first2=Gaia |last3=Guazzi |first3=Marco |last4=Palermo |first4=Pietro |last5=Bussotti |first5=Maurizio |last6=Marenzi |first6=Giancarlo |date=1 November 2000 |title=Cardiomegaly as a possible cause of lung dysfunction in patients with heart failure |journal=American Heart Journal |volume=140 |issue=5 |pages=A17–A21 |doi=10.1067/mhj.2000.110282 |pmid=11054632}} * {{Cite journal |last=Luedde |first=Mark |last2=Katus |first2=Hugo |last3=Frey |first3=Norbert |date=1 January 2006 |title=Novel Molecular Targets in the Treatment of Cardiac Hypertrophy |journal=Recent Patents on Cardiovascular Drug Discovery |volume=1 |issue=1 |pages=1–20 |doi=10.2174/157489006775244290 |pmid=18221071}}

== External links == {{Medical resources | ICD10 = {{ICD10|I|51|7|i|30}} | ICD9 = {{ICD9|429.3}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | DiseasesDB = 30769 | MeshID = D006332 }} * [http://www.heart.org/HEARTORG/Conditions/HeartFailure/AboutHeartFailure/Enlarged-Heart_UCM_450777_Article.jsp American Heart Association]

Category:Cardiomegaly